小剂量罗哌卡因腰硬联合麻醉用于高龄老年患者下肢骨折手术的临床观察

目的探究0.5%罗哌卡因小剂量腰硬联合麻醉在高龄老年患者下肢骨折手术中应用的安全性与有效性。方法对90例高龄老年骨折患者采用侧卧位单间隙腰硬联合麻醉,腰麻视者年龄及一般情况注入0.5%罗哌卡因,经硬膜外腔向头侧置入硬膜外导管,建立完善的血流动力学监测。检测收缩压（SBP）、舒张压（DBP）、呼吸（HR）、血氧饱和度（SpO2）,记录患者运动时间阻滞效果数据及术中并发症。结果麻醉起效时间短,效果满意,能满足手术需要。蛛网膜下腔给药后120min内各时点的SBP、DBP、HR、SpO2等与麻醉前比较,差异无统计学意义（P〉0.05）。术中镇痛效果完善,并发症的发生率较低。结论 0.5%罗哌卡因小剂量腰硬联合阻滞能很好满足高龄老年患者下肢手术的麻醉要求,安全有效,且无明显的不良反应。

Clinical observation of combined spinal-epidural anesthesia with ropivacaine with low-dose in the elderly lower limb surgery

Objective To discuss the safety and validity of combined spinal-epidural anesthesia with 0.5% ropivacaine with low-dose in the elderly lower limb surgery.Methods 90 cases patients accepted single space combined spinal-epidural anesthesia,accorded to the patient＇s age and general situation,injected 0.5% ropivacaine in spinal anesthesia.Checked the SBP、DBP、HR、SpO2 informations and recorded performance data block with exercise time and intraoperative complications.Results The anesthetic had short onset time and had satisfactory effect,could meet the required surgery.Among 120min since subarachnoid administration,the level of SBP,DBP,HR,SpO2 compared with the basic value of preoperative comparison,there was no significant difference（P〈0.05）.The analgesic effect of surgery was perfect and had a lower incidence of complications.Conclusion Combined spinal-epidural anesthesia with 0.5% ropivacaine with low-dose will fully meet the needs of the elderly lower limb surgery,it is reliable and effective,and has fewer obvious adverse reactions.