盐酸甲氧明对腰硬联合麻醉下行膝关节置换术老年患者血流动力学的影响

Study on the hemodynamic effect of methoxamine in elderly patients undergoing knee joint replacement surgery under combined spinal epidural anesthesia

目的评估盐酸甲氧明对腰硬联合麻醉下行膝关节置换术的老年患者血流动力学的影响。方法选拟于腰硬联合麻醉下行膝关节置换术的老年患者60例,随机分为甲氧明组和麻黄素组,每组30例。甲氧明组和麻黄素组分别在患者出现低血压时缓慢(30 s)静注盐酸甲氧明1 mg和麻黄素5 mg。记录并比较两组心血管不良事件的发生例数及总次数。结果甲氧明组心血管不良事件的发生例数及总次数均低于麻黄素组,两组比较有显著性差异(P<0.05)。结论盐酸甲氧明能有效维持腰硬联合麻醉下行膝关节置换术的老年患者血流动力学稳定。

Objective To evaluate the effect of methoxamine on hemodynamics in elderly patients undergoing knee joint replacement sur- gery under combined spinal epidural anesthesia. Methods 60 elderly patients undergoing knee joint replacement surgery under combined spinal epidural anesthesia were randomly divided into methoxamine group and ephedrine group, 30 cases in each group. One mg methoxamine （ methox- amine group） or 5 mg ephedrine （ephedrine group） was slowly intravenously injected within 30 seconds when the patient was under hypotension. The number of cases and the total incidence of adverse cardiovascular events were recorded and compared. Results The number of cases and the total incidence of adverse cardiovascular events in methoxamine group were significantly lower than those of ephedrine group （ P 〈 0.05 ）. Con- elusion Methexamine can maintain the stability of hemodynamics in elderly patients with knee joint replacement surgery under combined spinal and epidural anesthesia.