老年经尿道前列腺电切手术患者的2种麻醉方法比较研究

Comparison of two anesthesia methods for elderly patients undergoing transurethral resection of prostate

目的比较左旋布比卡因与罗哌卡因腰-硬联合麻醉对老年经尿道前列腺电切术患者术后呼吸功能的影响。方法选取收治的前列腺增生患者104例为研究对象,根据随机数字表法将患者分为罗哌卡因组和左旋布比卡因组,每组52例。罗哌卡因组采用0.5%罗哌卡因麻醉,左旋布比卡因组采用0.3%左旋布比卡因麻醉。比较2组感觉和运动阻滞情况、麻醉前后血流动力学变化、呼吸功能相关指标变化及不良反应发生率。结果罗哌卡因组感觉和运动阻滞起效时间长于左旋布比卡因组,感觉和运动阻滞维持时间短于左旋布比卡因组,差异均有统计学意义(P<0.05);2组麻醉不同时点平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO 2)比较,差异无统计学意义(P>0.05);麻醉后,罗哌卡因组呼气高峰流量(PEFR)及第1秒用力呼气量(FEV 1)高于左旋布比卡因组,差异有统计学意义(P<0.05);罗哌卡因组不良反应总发生率低于左旋布比卡因组,但差异无统计学意义(P>0.05)。结论老年经尿道前列腺电切术患者采用罗哌卡因腰-硬联合麻醉,运动恢复较快,呼吸系统受影响较小,安全性较高。

Objective To compare the effect of combined spinal-epidural anesthesia of levobupivacaine and ropivacaine on postoperative respiratory function in elderly patients undergoing transurethral resection of prostate.Methods A total of 104 patients with prostatic hyperplasia were selected and divided into ropivacaine group and levobupivacaine group according to random number table method,with 52 cases in each group.The ropivacaine group was given 0.5% ropivacaine,and the levobupivacaine group was given 0.3% levobupivacaine for anesthesia.The conditions of sensory and motor blocks,hemodynamic changes before and after anesthesia,changes of respiratory function-related indicators and incidence rate of adverse reactions were compared between the two groups.Results The onset time of sensory and motor block in the ropivacaine group was longer than that in the levobupivacaine group,and the duration of sensory and motor block was shorter than that in the levobupivacaine group(P<0.05).There were no significant differences at different time points of anesthesia in the mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SpO2)between the two groups(P>0.05).After anesthesia,the peak expiratory flow rate(PEFR)and forced expiratory volume in 1 second(FEV1)in the ropivacaine group were significantly higher than those in the levobupivacaine group(P<0.05).The total incidence rate of adverse reactions in the ropivacaine group was significantly lower than that in the levobupivacaine group,but no significant difference was found in two groups(P>0.05).Conclusion Combined spinal-epidural anesthesia of ropivacaine for elderly patients undergoing transurethral resection of prostate has faster motor recovery,less effects on respiratory system and higher safety.