老年硬膜外麻醉下阑尾切除术中精准麻醉理念的应用效果

Application effect of precise anesthesia concept in elderly patients undergoing appendectomy with epidural anesthesia

目的分析老年硬膜外麻醉下阑尾切除术中精准麻醉理念的应用效果。方法回顾性分析我院2016年1月至2016年12月收治的80例老年硬膜外麻醉下阑尾切除术患者的临床资料,根据不同麻醉剂量分为研究组与对照组,各40例。两组患者均给予T^(12)~L_1间隙硬膜外穿刺,穿刺完成之后给予2%利多卡因5 mL注入,5 min后对相对阻滞平面予以测试,然后再将0.5%罗哌卡因与0.67%利多卡因混合液予以注入,研究组注入剂量为5 mL,对照组注入剂量为10 mL,10 min之后对绝对平面予以测定。结果注射基础剂量5 min后,两组患者胸脊神经节段扩散节数比较,差异无统计学意义(P>0.05);注射追加剂量10 min后,两组患者胸脊神经节段扩散节数比较,差异有统计学意义(P<0.05);两组患者每毫升混合液增加的胸脊神经节段比较,差异无统计学意义(P>0.05)。结论老年硬膜外麻醉下阑尾切除术治疗过程中,通过注射基础剂量测得的阻滞平面上界与T5的距离,然后按照公式对追加剂量参考值进行计算,根据计算结果确定给药剂量,能够获取较为精准的阻滞平面。

Objective To analyze applicalion effecl of precise aneslhesia concepl in elderly palienls undergoing appendeclomy wilh epidural aneslhesia. Methods The clinical dala of 80 palienls undergoing appendeclomy wilh epidural aneslhesia were relrospeclively analyzed, all lhe palienls were divided inlo sludy group and conlrol group, wilh 40 cases in each group. Palienls in lhe lwo groups were given T12-L1 gap epidural punclure; afler lhe complelion of lhe injeclion, 2 % lidocaine 5 mL was injecled, and lhe elalive block plane was delecled al 5 min laler. Then lhe mixlure of 0.5% ropivacaine and 0.67% lidocaine was injecled, and lhe injeclion dose of lhe sludy group was5 mL, and lhal of lhe conlrol group was 10 mL, and lhe elalive block plane was delecled al 10 min laler. Results There was no significanl difference in lhoracic spinal ganglion segmenl diffusion seclion number al 5 min afler lhe basic dose injeclion belween lhe lwo groups （ P〉0.05）; bul il had significanl difference al 10 min afler lhe boosl dose injeclion （ P〈0.05）; and lhere was no significanl difference in lhoracic spinal ganglion segmenl diffusion seclion number each millililer mixlure increased （ P〉0.05）. Conclusion In elderly palienls undergoing appendeclomy wilh epidural aneslhesia, lo measure lhe dislance belween lhe upper bound and lhe T5 of lhe block plane by basic dose injeclion, and lhen lo delermine lhe dosage according lo lhe calculalion resulls can oblain more accurale blocking plane.