小剂量布比卡因腰硬联合麻醉与罗哌卡因硬膜外麻醉对老年患者麻醉效果对比观察

The Comparison of Anesthesia Effect of Small Dose Bupivacaine Combined Spinal Epidural Anesthesia and Ropivacaine Epidural Anesthesia on Elderly Patients

目的对比小剂量布比卡因腰硬联合麻醉与罗哌卡因硬膜外麻醉在老年患者手术麻醉中的应用效果。方法筛选2013年4月至2014年4月于我院进行择期手术老年患者84例作为研究对象。采用随机数表法将所有患者分为观察组与对照组,每组42例,其中对照组于罗哌卡因硬膜外麻醉下进行手术,观察组采取小剂量布比卡因腰硬联合麻醉下进行手术治疗,比较两组患者麻醉起效时间、最大运动组织程度、术中血压变化情况及不良反应发生情况。结果两组患者麻醉效果均表现良好,但观察组麻醉起效时间明显短于对照组(P<0.05),并且Bromage最大运动阻滞评分明显高于对照组(P<0.05);观察组术中及术后不良反应发生率明显低于对照组(P<0.05)。结论老年患者手术麻醉小剂量布比卡因腰硬联合麻醉具有较好的麻醉效果,其麻醉起效时间快,低剂量麻醉剂应用可显著降低术中、术后不良反应发生率,是一种安全、有效的麻醉方式。

Objective To compare anesthesia effect of small dose Bupivacaine combined spinal epidural anesthesia and Ropivacaine epidural anesthesia on elderly patients.Methods 84 elderly patients undergoing selective operation between April,2013 and April,2014 in our hospital were selected as the research object.84 cases were divided into observation group and control group by using stochastic way,42 cases in each group.The control group received the surgery under Ropivacaine epidural anesthesia and the observation group was for small dose Bupivacaine combined spinal epidural anesthesia.The anesthesia effect time,maximum movement degree,intraoperative blood pressure changes and adverse reactions in the two groups were compared.Results The anesthesia effect in both groups was good,but anesthesia effect time of the observation group was obviously shorter than that of the control group.The biggest sports block score Bromage was significantly higher than that of the control group（ P〈0.05） with statistical significance.The adverse reaction of intraoperative and postoperative time in the observation group was obviously lower than that of the control group（ P〈0.05） with statistical significance. Conclusion The small dose Bupivacaine combined spinal epidural anesthesia for elderly patients has good anesthesia effect and faster anesthesia effect.The application of low doses of narcotic can significantly reduce the intraoperative and postoperative adverse reactions.It is a safe and effective way of anesthesia.