单侧蛛网膜下腔阻滞对老年患者循环呼吸系统的影响

目的通过在腰硬联合麻醉中使用单侧阻滞,探讨减少蛛网膜下腔麻醉对老年患者循环呼吸影响的方法。方法选择择期行单侧下肢手术患者40例,随机分为两组。A组行单侧蛛网膜下腔阻滞;B组行常规腰硬联合麻醉。比较给药后第3、5、10、15、20min时对两组患者平均动脉压(MAP)、心率(HR)、氧饱和度(SpO2)的影响。结果两组患者患侧运动阻滞程度无明显差别(P>0.05),A组的感觉阻滞范围略宽,健侧的感觉运动阻滞A组均较B组为轻,二者差异有统计学意义(P<0.05)。所有患者均顺利完成手术。两组在各个记录点的MAP,及第5、10、15min的HR差别均有统计学意义(P<0.01)。所有患者都未出现呼吸抑制。结论在腰硬联合麻醉中使用单侧蛛网膜下腔阻滞可以满足手术需求,对老年患者的呼吸循环影响轻微,有利于减少老年患者的麻醉并发症。

Effects of unilateral spinal anesthesia in the elder patients circulation and respiration

Objective To evaluate the effects of unilateral spinal anesthesia on elder patients circulation andrespiration in order to explore the appropriate methods for decreasing the influences of combined epidural - spinalanesthesia for elder patients. Methods 40 patients undergoing selective unilateral lower limb surgery were randomlydivided into 2 groups. Group A underwent unilateral spinal anesthesia, while group B underwent routine combinedepidural- spinal anesthesia. The mean artery pressure ( MAP) , heart rate ( HR) and saturation pulse oxygen( SPO2)after giving the initial local anesthetic doses at the time- points of 3 min, 5 min, 10 min, 15 min and 20 min in bothgroups were recorded. Results There was no significant difference on the motion block degree in operation side ( P>0.05) . While in the non- operational side, patients in group B showed significant motion block ( P<0.05) . No patientshad complications. There were significant differences among MAP and HR in all recording time- points. No patients hadrespiratory inhibition. Conclusion Unilateral spinal block combined with epidural - spinal anesthesia could supplyenough anesthesia for elderly patients surgery with little inhibition on circulation and respiration system, that mayminimize the anesthesia related complications.