0.3%布比卡因用于老年人腰麻硬膜外联合麻醉临床研究

目的:研究腰硬联合麻醉用于老年人下肢手术的可行性和安全性。方法:40例老年人患者随机分成腰硬联合麻醉(CSEA)组和连续硬膜外阻滞(CEA)组。CSEA组应用0.3%布比卡因2～2.5ml,CEA应用1%利多卡因和0.375%布比卡因混合液。各组注药后分别记录感觉阻滞起效时间、感觉平面固定时间、首次麻醉维持时间、运动阻滞起效时间、最大运动阻滞时间、Bro-mage评分;记录术中低血压、寒战、恶心呕吐及术后尿潴留、头痛等不良反应。结果:两组在感觉阻滞起效时间,感觉平面固定时间,首次维持时间及运动阻滞起效时间、最大运动阻滞时间均有显著性差异(P=0.000)、Bromage评分上亦有显著性差异(P=0.022),但两组血压下降、寒战、恶心呕吐及术后头痛、尿潴留等不良反应无显著差异(P=1.000)。结论:0.3%布比卡因腰麻硬膜外联合麻醉用于老年患者下肢手术是安全的,术中麻醉效果满意,不良反应少。

Clinical Study On Combined Spinal-epidural Anesthesia with 0.3%bupivacaine in the Elderly

Objective： To study the feasibility and safety of 0.3% bupivacaine used for combined spinal-epidural anesthesia in the elderly undergoing lower limb operation.Methods： Forty patients were randomly divided into continous epidural anesthesia（CEA） group and CSEA group.2～2.5ml 0.3% bupivacaine were used in CSEA group,mixture of 1% lidocaine and 0.375% bupivacaine in CEA group.The two group were assessed for the onset time of sensory and motor block,the sensory plane fixed time,the maximum motor block time,modified Bromage scale.Also,we recorded the occurrence of side effects,including the intraoperative hypotension,chills,nausea and vomiting and postoperative urine retention,headaches.Results： There were significant differences in the onset time of sensory and motor block,the sensory plane fixed time,the maximum motor block time（P=0.000）,modified Bromage scale（P=0.022） between the two group.Meanwhile,no obvious side effects were found in two group.Conclusion： Combined spinal-epidural anesthesia with 0.3% bupivacaine is safe and sufficient in the elderly undergoing lower limb operation.