超高龄髋部骨折术后0．25％罗哌卡因自控镇痛疗效观察

目的观察0．25％罗哌卡因硬膜外自控镇痛用于超高龄髋部骨折患者术后的疗效及安全性。方法60例ASAⅡ～Ⅲ级，年龄81～106岁，具备能与正常人基本沟通能力的择期行髋部骨折手术的患者。手术结束前约30min经硬膜外导管给0．25％罗哌卡因5ml后连接自控镇痛输液泵，泵设置总量100ml，流量速度2ml／h，自控追加量2ml／次．自控间隔锁定时间为20min。测定术后4，8，12，24，36，48小时VAS，记录运动恢复情况及不良反应。结果术后镇痛效果均满意，运动恢复良好，无呼吸抑制、神经系统并发症及恶心、呕吐发生。结论0．25％罗哌卡因硬膜外自控镇痛用于超高龄髋部骨折患者术后效果确切，安全性较高。

Effects of Ropivacaine on Postoperative Patient-controlled Analgesia in Very Elderly Patients with Hip Fracture

Objective To oberserve the effects and safety of ropivacaine on postoperative patient-controlled epidural analgesia in very elderly patients with hip fracture. Methods Sixty patients with hip fracture,ASA grade Ⅱ～Ⅲ ,age 81-106 years,with normal communication ability, and scheduled for elective hip surgery, were choosed in this stydy. 5 ml 0.25 % ropivacaine was given by epidural catheter 5 minutes before the end of operation, and the patient-controlled epidural analgesia infusion pump was set： the total volum dose was 100ml,velocity was 2 ml/h,self-co ntrol repeated maintenance dose was 2 ml every time,and the auto interval time was 20 min. The visual analog scale scores（VAS） at 4,8,12,24,36,48 hours after the operation were detected. The block of motor nerve and incidence of side-effect were observed. Results Ropivacaine offered a satifactory analgesia effect without the adverse effects such as respiratory depression, neurologic complications, nausea and vomiting, and the motor recoveried well. Conclusion Ropivacaine has exact effect and fine security on the postoperative patient-controlled epidural analgesia in very elderly patients with hip fracture.