甲磺酸罗哌卡因硬膜外麻醉用于高龄老年患者的临床效果

目的探讨不同浓度甲磺酸罗哌卡因用于高龄老年下肢骨折手术硬膜外麻醉的临床效果。方法将56例拟行下肢骨折切开复位内固定术的80岁以上患者随机分为两组：I组用1．192％甲磺酸罗哌卡因麻醉，Ⅱ组用0．596％甲磺酸罗哌卡因，观察两组循环变化、甲磺酸罗哌卡因的用量、阻滞起效时间、脊神经阻滞节段及麻醉持续时间，记录术中不良反应发生率。结果麻醉后I组血压下降幅度大于Ⅱ组（P〈0．05）；两组甲磺酸罗哌卡因用量1组（41±9）mg，II组（37±15）mg，组间比较差异无统计学意义（P〉0．05）。阻滞起效时间I组短于Ⅱ组（P〈0．01），脊神经阻滞节段Ⅱ组多于I组（P〈0．05），I组麻醉持续时间长于Ⅱ组（P〈0．01），两组低血压发生率比较差异无统计学意义。结论甲磺酸罗哌卡因可安全地用于高龄老年下肢骨折手术的硬膜外麻醉，麻醉维持期要注意血容量的补充，避免发生低血压。

Clinical effectiveness of ropivacaine mesylate in epidual anesthesia in the elderly patients

Objective To compare the clinical effectiveness of ropivacaine mesylate in different concentration for epidual anesthesia in the elderly patients undergoing lower limb procedures. Methods Fifty - six patients （ aged above 80 years） undergoing epidural anesthesia for lower limb procedures were randomly divided into two groups, group I （ n =28） recived 1. 192% ropivacaine mesylate in anesthetic while group II （ n = 28） reeived 0. 596% ropivacaine mesylate. We recorded the changes of hemody namics, the dosage roplvacalne the anesthesia start time, the sections of the backbone nerves and mesylate, anesthesia the anesthesia duration. Results Significant difference of the decline of MAP after anesthesia was found between the two groups （P 〈 0.05）. The dosage of ropivacaine mesylate was similar in the two groups （P 〉 0.05）. The anesthesia start time was significantly shorter in group I than that in group II （P 〈 0.01 ）. The anesthesia sections of the backbone nerve in group II was wider than that in group I （P 〈 0.05）. The anesthesia duration was longer in group I than that in group II （P 〈 0.01 ）. Conclusions Ropivacaine mesylate is safely used for epidual anesthesia in the aged undergoing lower limb procedures. It is important to stabilize hemodynamics during the anesthesia duration.