布比卡因复合舒芬太尼腰-硬联合麻醉在老年下肢骨折手术中的应用

目的:探讨布比卡因复合舒芬太尼腰-硬联合麻醉在老年下肢骨折手术中的应用。方法:将60例老年下肢骨折手术患者随机分为单纯布比卡因组（A组），布比卡因复合舒芬太尼组（B组），每组30例。A组给予布比卡因7.5 mg+0.9%氯化钠注射液0.5 ml，B组给予布比卡因7.5 mg复合舒芬太尼5 μg+0.9%氯化钠注射液0.4 ml。观察患者感觉阻滞起效时间、阻滞程度、持续时间、运动阻滞持续时间和改良Bromage评分，术中、术后瘙痒、恶心呕吐情况。结果:2组患者感觉阻滞起效时间差异无统计学意义（P>0.05），与A组比较，B组感觉阻滞持续时间明显延长，感觉阻滞最高平面明显升高（P<0.01），2组患者改良Bromage评分和运动阻滞持续时间差异均无统计学意义（P>0.05），术中、术后不良反应差异均无统计学意义（P>0.05）。结论:小剂量布比卡因复合舒芬太尼腰-硬联合麻醉应用于老年下肢骨折手术较为安全有效。

The bupivacaine combined with sufentanil application in spinal-epidural anesthesia of the elderly lower limb fracture surgery

Objective：To investigate the bupivacaine combined with sufentanil application in spinal-epidural anesthesia of the elderly lower limb fracture surgery.Methods：Sixty elderly patients undergone lower limb surgery were randomly divided into bupivacaine group （A group,30 cases） and bupivacaine combined with sufentanil group（B group,30 cases）.Group A and B were treated with the 0.5 ml mixture of 7.5 mg bupivacaine and 0.9％ sodium chloride,and 0.4 ml mixture of 7.5 mg bupivacaine combined with 5 μg sufentanil and 0.9％ sodium chloride,respectively.The onset time,degree and duration time of sensory block,and duration time of motor block,modified Bromage score,and the intraoperative and postoperative itching,nausea and vomiting in two groups were observed.Results：The differences of the onset time of sensory block,modified Bromage score,duration time of motor block and intraoperative and postoperative adverse reactions between two groups were not statistically significant（P ＞ 0.05）.Compared with A group,the duration time and highest plane of sensory block in B group were significantly prolonged and high（P ＜ 0.01）.Conclusions：The bupivacaine combined with sufentanil application in spinal-epidural anesthesia of the elderly lower limb fracture surgery is more safe and effective.