罗哌卡因和布比卡因腰硬联合麻醉应用于老年妇科手术临床效果分析

目的:旨在比较分析罗哌卡因和布比卡因腰硬联合麻醉应用于老年妇科手术麻醉效果、安全性和意义。方法:收集拟行妇科手术且ASA分级Ⅰ～Ⅱ级的老年患者70例,随机分为布比卡因组(A组)和罗哌卡因组(B组)各35例。采用腰硬联合麻醉,记录并分析术前、术中和术后血流动力学和感觉及运动阻滞参数、不良反应和并发症等情况。结果:两组麻醉效果优良率均为100%;A组麻醉后血压及心率下降程度明显高于B组且P<0.05;A组运动阻滞起效时间和感觉恢复时间快于B组且P<0.05,而运动恢复时间慢于B组且P<0.05;A组出现低血压和恶心呕吐患者明显多于B组且P<0.05。结论:罗哌卡因和布比卡因应用于老年妇科手术腰硬联合麻醉均取得满意麻醉效能,鉴于老年妇女体质弱和手术耐受性差等因素,罗哌卡因应作为老年妇科手术麻醉首选。

The Clinical Effect of Ropivacaine and Bupivacaine in Epidural Anesthesia for Elderly Gynecological Surgery

Objective:To analysis the anesthetic effect,safety and sense of ropivacaine and bupivacaine epidural anesthesia in elderly gynecological surgery.Methods:Collected 70 patients with ASA grade Ⅰ~Ⅱ who acceptted gynecological surgery,Randomly divided into bupivacaine group(A) 35 cases and the ropivacaine group(B) 35 cases.All use of epidural anesthesia for surgery,Recorded and analyzed the hemodynamic,sensory and motor block parameters,adverse reactions and complications,etc.Results:The excellent rate of two groups were 100%;A group of blood pressure and heart rate decreased after anesthesia was significantly higher than the group B(P<0.05);A group of motor block onset time and sensory recovery time was faster than the group B(P<0.05),but the exercise recovery time was slower than the group B(P<0.05);A group of patients with hypotension,nausea and vomiting was higher than group B(P<0.05).Conclusion:Ropivacaine and bupivacaine in elderly gynecological surgery epidural anesthesia can provide satisfactory anesthesia performance,In view of older women’s physical weakness and poor tolerance to surgery factors,ropivacaine should be preferred as the elderly gynecological surgery.