罗哌卡因腰麻硬膜外联合麻醉在老年下肢手术中的效果观察

Observation of Combined Spinal-epidural Anesthesia with Ropivacaine in the Lower Extremity Surgery on Aged Patients

目的:对罗哌卡因腰硬联合麻醉在老年患者下肢手术中的临床效果及安全性进行探讨。方法:选择在腰硬联合麻醉下择期行下肢手术的老年患者90例,随机分为R组和B组,每组45例,R组患者给予注射0.75%的盐酸罗哌卡因1.2mL,B组患者注射0.75%的盐酸布比卡因1.2mL,麻醉实施后对两组患者的感觉、运动阻滞情况和不良反应进行观察。结果:两组患者麻醉后,在感觉阻滞起效时间、最高感觉阻滞平面、T12阻滞维持时间方面差异不显著(P>0.05),但R组患者相比B组,其运动阻滞起效时间更长,最大Bromage评分更小,Bromage 1分的维持时间更短(P<0.05);在不良反应发生率方面,两组患者比较差异不显著(P>0.05)。结论:罗哌卡因腰硬联合麻醉用于老年下肢手术效果显著,不良反应小,值得临床推广使用。

Objective：To investigate the clinical effect and safty of ropivacaine combined spinal-epidural anesthesia in the lower extremity surgery on aged patients.Methods：90cases of elderly patients who would receive the lower extremity surgery under combined spinal-epidural anesthesia were selected and randomly divided into group R and group B,45 cases in each group.Patients in Group R were given injection of 0.75%ropivacaine hydrochloride 1.2mL,and group B was treated with injection of 0.75% bupivacaine hydrochloride 1.2mL.The feeling,motor block and adverse reactions of two groups patients were observed after anesthesia.Results：After anesthesia,the differences of feeling block onset time,peak sensory block level and T12 block maintenance time of patients in two groups were not significant（P〉0.05）,but compared with group B,the motor block onset time of R group was longer,maximum bromage score was smaller,holding time of bromage 1point was shorter（P〈0.05）;The difference of the incidence of adverse reactions between the two groups was not significant（P〉0.05）.Conclusion：Ropivacaine combined spinal-epidural anesthesia for elderly patients with lower extremity surgery has significant effect,less adverse reactions,which is worthy of clinical promotion and application.