小剂量不同浓度罗哌卡因麻醉在老年膝髋关节置换中的价值研究

The value of low dose ropivacaine anesthesia in elderly knee and hip replacement

目的探讨小剂量不同浓度罗哌卡因麻醉在老年膝髋关节置换中的价值。方法选自本院于2016年6月至2017年6月期间收治老年膝髋关节置换术患者92例,按照随机表法分为A组与B组,各46例。A组注入0.25%浓度罗哌卡因,B组注入0.50%浓度罗哌卡因。比较两组麻醉持续时间、运动恢复时间和感觉恢复时间,健侧下肢运动神经阻滞情况,不同麻醉时间心率和平均动脉压(MAP)变化,及不良反应发生情况。结果A组麻醉持续时间短于B组,运动恢复时间和感觉恢复时间短于B组,均有统计学差异(P<0.05);A组健侧下肢运动神经阻滞Ⅰ级多于B组,Ⅲ级少于B组,均有统计学差异(P<0.05);两组麻醉5 min和10 min心率和MAP降低(P<0.05);A组麻醉5 min、10 min和30 min心率和MAP低于B组(P<0.05);A组不良反应发生率(13.04%)低于B组(34.78%)(P<0.05)。结论0.25%浓度罗哌卡因在老年膝髋关节置换中效果优于0.50%浓度罗哌卡因,且不良反应少,具有重要研究价值。

Objective To investigate the value of low dose ropivacaine anesthesia in the elderly knee and hip replacement.Methods 92 elderly patients with knee and hip replacement were selected from our hospital from June 2016 to June 2017.They were divided into A group and B group according to the random list,each with 46 cases.A group was injected with 0.25%concentration ropivacaine,and B group was injected with 0.50%concentration ropivacaine.Comparison of two groups of anesthesia duration,recovery time and feel the recovery time,the situation of contralateral llmb,different anesthesia time heart rate and mean arterial pressure(MAP)changes,and the incidence of adverse reactions.Results in group A,anesthesia duration was shorter in the B group,the movement recovery time and sensory recovery time shorter in the B group(P<0.05);A group of contralateral llmb I than that of B group,B group is less than Ⅲ,there were statistically significant differences(P<0.05);between the two groups 5 min and 10 min heart rate and MAP decreased(P<0.05);A group anesthesia 5min,10 min and 30 min heart rate and MAP lower than that of B group(P<0.05);the incidence of adverse reactions in group A(13.04%)than in the B group(34.78%)(P<0.05).Conclusion 0.25%ropivacaine is better than 0.50%ropivacaine in the elderly knee joint replacement,and has less adverse reactions,so it has important research value.