罗哌卡因复合舒芬太尼腰硬联合麻醉在老年患者下肢骨科手术中的应用

Application of Ropivacaine Combined with Sufentanil Combined with Spinal Anesthesia in Lower Extremity Orthopedic Surgery in Elderly Patients

目的观察罗哌卡因复合舒芬太尼腰硬联合麻醉在老年患者下肢骨科手术中的应用效果。方法选择该院2016年6月—2017年12月间择期行下肢骨科手术老年患者60例,随机分为罗哌卡因复合舒芬太尼组(RS组,n=30)和单纯罗哌卡因组(R组,n=30)。RS组蛛网膜下腔内注射罗哌卡因10 mg+舒芬太尼5μg,R组蛛网膜下腔内注射罗哌卡因12 mg。观察两组感觉阻滞的起效及恢复时间,运动阻滞评分及恢复时间,麻醉效果,低血压、心动过缓、恶心呕吐、寒战及呼吸抑制等麻醉不良反应情况。结果 RS组的感觉阻滞起效时间明显短于R组[(12.2±2.5)min vs (15.4±2.0)min(t=5.474 6,P<0.05),两组运动阻滞评分、感觉恢复时间、运动恢复时间差异无统计学意义[(295.6±32.0)min vs (302.5±28.5)min;(186.6±25.8)min vs (192.4±22.5)min;(2.9±0.3)min vs (2.8±0.4)min (t=0.881 9、0.928 0、1.095 4;P>0.05),RS组的麻醉效果明显优于R组90.00%vs 66.67%(χ~2=4.811 8,P<0.05),两组患者不良事件发生率差异无统计学意义(P>0.05)。结论罗哌卡因复合舒芬太尼腰硬联合麻醉在老年患者下肢骨科手术中的应用是安全有效的。

Objective To observe the effect of ropivacaine combined with sufentanil combined with spinal anesthesia in the lower extremity orthopedic surgery of elderly patients.Methods 60 elderly patients who underwent elective lower extremity orthopedic surgery from June 2016 to December 2017.They were randomly divided into the ropivacaine-associated sufentanil group(RS group,n=30)and ropivacaine alone group(R group,n=30).RS group received subarachnoid injection of ropivacaine 10 mg + sufentanil 5 μg,group R subarachnoidally injected ropivacaine 12 mg.The onset and recovery time,motor block score and recovery time,anesthesia effect,hypotension,bradycardia,nausea and vomiting,chills and respiratory depression were observed.Results The onset time of sensory block in the RS group was significantly shorter than that in the R group [(12.2±2.5)min vs(15.4±2.0)min(t=5.474 6,P<0.05).The motor block score and sensory recovery time of the two groups.There was no significant difference in exercise recovery time [(295.6±32.0)min vs(302.5±28.5)min;(186.6±25.8)min vs(192.4±22.5)min;(2.9±0.3)min vs(2.8±0.4)min(t=0.881 9,0.928 0,1.095 4;P>0.05),the anesthetic effect of the RS group was significantly better than the R group 90.00% vs 66.67%(χ^2=4.811 8,P<0.05),adverse events occurred in the two groups.There was no significant difference in the rate(P>0.05).Conclusion Ropivacaine combined with sufentanil combined with spinal anesthesia is safe and effective in the treatment of lower extremity orthopedic surgery in elderly patients.