布比卡因复合小剂量芬太尼腰-硬联合麻醉在老年患者经尿道前列腺电切术的临床应用

目的探讨布比卡因复合小剂量芬太尼腰-硬联合麻醉在老年患者TURP临床应用的安全性和有效性。方法40例择期行TURP老年患者,随机均分为B组和BF组,均蛛网膜下隙注药,B组：布比卡因10mg;BF组：布比卡因7．5mg＋芬太尼20μg。监测：①蛛网膜下隙注药前,注药后2、5、10、20、30min的血压和心率;②最高感觉阻滞平面和感觉阻滞时间;③运动神经阻滞情况;④麻醉效果;⑤记录恶心、呕吐、皮肤瘙瘁、呼吸抑制、术后头痛等并发症。结果BF组血流动力学稳定,B组有4例低血压、3例心动过缓。两组最高感觉阻滞平面比较差异无统计学意义（P〉0．05）：BF组感觉阻滞时间较B组长（P〈0．05）、而运动阻滞程度低于B组（P〈0．05）。两组麻醉效果均完善。结论布比卡因复合小剂量芬太尼腰．硬联合麻醉可以安全、有效地应用于老年患者TuRP的麻醉。

Application of spinal-epidural anesthesia with bupivacaine combined with low dose fentanyl in the elderly undergoing TURP surgery

Objective To evaluate the safety and effectiveness on application of combined spinal-epidural anesthesia with bupivacaine combined with low dose fentanyl in the elderly undergoing transurethral resection of the prostate（TURP） surgery. Methods 40 elderly patients who would undergo TURP surgery. They were divided into group B and group BF randomly of 20 patients each. Group B received a spinal anesthesia of bupivacaine 10mg. Group BF received bupivacaine 7.5mg plus fentanyl 20μg. Blood pressure（ BP）and heart rate（ HR）were measured at before performance of spinal blockage and 2min, 5min, 10min, 20min, 30min after intrathecal injection. The peak sensory block plane,duration of sensory block,maximum motor block,the an- esthesia effect and side-effect were recorded. Results The hymodynamic was stable in group BF,4 cases had the hypotension and 3 cases had the bradycarida in group B. No difference was detected in the peak sensory block plane between two groups （P〉 0.05）. The duration of sensory block was longer in group BF than that in group B （ P〈0. 05 ）. The intensity of maximum motor block evaluated with bromage scale in group BF was lower than that in group B（P〈0. 05）. Two groups could provide better con- summate anesthesia. The side-effect was limited in two groups. Conclusion Application of spinal-epidural anesthesia with bupiv- acaine combined with low dose fentanyl can be safe and effective for the elderly undergoing TURP surgery.