不同剂量与浓度的布比卡因对老年骨科手术患者进行硬—腰联合麻醉的效果分析

Clinical effective analysis of different doses and concentrations of bupivacaine for spinal and epidural anesthesia in elderly patients with orthopaedic surgery

目的探讨不同剂量与浓度的布比卡因对老年骨科手术患者进行硬-腰联合麻醉的效果。方法对我院收治的80例老年骨科手术患者均选择布比卡因进行硬-腰联合麻醉,根据布比卡因的剂量与浓度的不同将其分为两组,各40例。对照组采用浓度为0.50%、剂量为10~15 mg的布比卡因,研究组采用浓度为0.25%、剂量为5 mg的布比卡因,观察两组患者麻醉前、后体征变化及不良反应发生情况。结果麻醉后,两组患者的心率、收缩压、舒张压均有所降低,术中、手术结束后有所升高,但观察组的变化较小,且心率、收缩压、舒张压均高于对照组(P<0.05);两组及组内各时间段的SPO_2比较,无显著差异(P>0.05)。两组不良反应总发生率比较,无显著差异(P>0.05)。结论对老年骨科手术患者行硬-腰联合麻醉时采用小剂量、低浓度布比卡因,可有效减少对机体循环系统的影响,且不良反应少。

Objective To discuss the efficacy of different doses and concentrations of bupivacaine in elderly patients with orthopaedic surgery. Methods A total of 80 cases of elderly patients performing orthopaedic surgery were given bupivacaine in the combination of spinal and epidural anesthesia. All the patients were divided into research group and control group according to different doses and concentrations of bupivacaine, with 40 cases in each group. Patients in the control group were given concentration of 0.50%, 10-15 mg bupivacaine, while patients in the research group were given concentration of 0.25%, 5 mg bupivacaine, and the changes of the signs and the occurrence of adverse reactions in the two groups were observed before and after anesthesia. Results After anesthesia, the heart rate, systolic blood pressure and diastolic blood pressure in the two groups decreased, and increased during operation and after surgery, but the observation group changed a little, and the heart rate, systolic blood pressure and diastolic blood pressure in the observation group were higher than those of the control group（P〈0.05）; there were no significant difference in SPO_2 between the two groups and each time period of the group（P〉0.05）, there was no significant difference in the incidence of adverse reaction in the two groups（P〉0.05）.Conclusion Small doses and lower concentrations of bupivacaine for spinal and epidural anesthesia in elderly orthopaedic surgery has exact effect with less adverse reactions, and can reduce the influences on the body circulation system.