布比卡因在高龄患者髋部手术中的应用

Application of Bupivacaine in Hip Surgery of Elderly Patients

在高龄髋部手术中,腰硬联合麻醉(CSEA)已得到广泛应用,其具有腰麻(SA)起效快、作用时间灵活、便于术后镇痛等优点。但由于高龄患者常常合并心血管等疾病,循环能力较差,血压波动较大。常规剂量的布比卡因可能导致血压下降、恶心、呕吐等不良后果,因此在高龄患者髋部手术中选用小剂量布比卡因可减少常规剂量带来的风险。本文就布比卡因的药理学及优势、高龄患者麻醉的特点及布比卡因在高龄患者中的临床应用进行综述,以期为临床合理用药提供参考。

In the elderly hip surgery,combined spinal-epidural anesthesia(CSEA)has been widely used.It has the advantages of rapid onset of spinal anesthesia(SA),flexible action time,and convenient postoperative analgesia.However,because elderly patients often have cardiovascular and other diseases,their circulatory capacity is poor and blood pressure fluctuates greatly.Conventional doses of bupivacaine may cause adverse effects such as blood pressure drop,nausea,and vomiting.Therefore,the use of small doses of bupivacaine in hip surgery of elderly patients can reduce the risk of conventional doses.This article reviews the pharmacology and advantages of bupivacaine,the characteristics of anesthesia in elderly patients,and the clinical application of bupivacaine in elderly patients,in order to provide references for clinical rational drug use.