小剂量腰麻联合硬膜外阻滞麻醉在高龄患者下肢手术中的应用

目的探讨小剂量腰麻联合硬膜外阻滞麻醉在高龄患者下肢手术中应用的临床效果。方法选择我院2010年1月～2011年1月收治的行下肢手术的高龄患者25例,随机分为对照组和观察组。对照组10例采用硬膜外麻醉,观察组15例采用小剂量腰麻联合硬膜外阻滞麻醉,比较两组麻醉起效时间、阻滞完善时间、硬膜外用药量和不良反应。结果观察组麻醉起效时间、阻滞完善时间均低于对照组,硬膜外用药量少于对照组,不良反应少于对照组(P<0.05);观察发现两组患者在心率(HR)、收缩压(SBP)、舒张压(DBP)的变化情况方面比较差异并不显著(P>0.05)。结论小剂量腰麻联合硬膜外阻滞麻醉具有麻醉起效快、阻滞完善、不良反应少等优点,适合高龄患者的手术治疗。

Effect of small dose of lumbar anesthesia combined with epidural block anesthesia in elderly patients with lower extremity operation

Objective To investigate the small dose of lumbar anesthesia combined with epidural anesthesia in elderly pa- tients with lower extremity operation in clinical effect. Methods In our hospital from 2010 January to 2011 January were lower limb operation in elderly patients with 25 cases, were randomLy divided into control group and observation group, two groups, 10 cases in the control group using epidural anesthesia, the observation group 15 cases treated with small dose of lumbar anesthesia combined with epidural block anesthesia, compared two groups of anesthetic onset time, complete block time, epidural drug dosage and adverse reaction. Results the observation group anesthetic onset time, complete block time were lower than the control group, epidural drug dosage less than that in the control group, the adverse reaction than that of control group （P 〈 0.05）; two patients were observed in heart rate （HR）, systolic pressure （SBP）, diastolic blood pressure （DBP） changes position difference not remarkable （P 〉 0.05 ）. Conclusion low dose spinal anesthesia combined with epidural block anesthesia with rapid onset, complete block, fewer adverse reactions and other advantages, suitable for elderly patients with operation treatment.