轻比重液腰硬联合麻醉在老年人下肢手术中的应用

目的探讨轻比重液腰硬联合麻醉用于老年患者下肢手术的有效性和安全性.方法 40例拟行下肢手术的老年患者,年龄61～92岁,按美国麻醉医师协会体格状况分级为Ⅰ～Ⅲ级,随机分为硬膜外麻醉组和腰硬联合麻醉组,每组20例.观察并记录两组麻醉显效时间,最高阻滞平面,到达最高阻滞平面时间,下肢运动神经阻滞的程度,血压和心率变化,麻黄碱和麻醉性镇痛药的使用情况,下肢运动功能恢复时间及有无术后头痛等并发症.结果①腰硬联合麻醉组麻醉显效时间、到达最高阻滞平面时间迅速,与硬膜外麻醉组比较有显著差异(P<0.05).②腰硬联合麻醉组镇痛完善,没有追加麻醉性镇痛药,硬膜外麻醉组有4例在辅用杜非合剂下完成手术;腰硬联合麻醉组有2例出现血压下降,硬膜外麻醉组7例出现血压下降,两组比较有显著性差异(P<0.05).③两组患者均无任何术后并发症.结论轻比重液腰硬联合麻醉能完全满足老年人下肢手术的麻醉要求,且无明显副作用.

Using Light Specific Gravity Bupivacaine in Combined Spinal and Epidural Anesthesia in Aged Patients Undergoing Lower Extremity Surgery

Objective To discuss the feasibility and safety of using specific gravity bupivacaine in combined spinal and epidural anesthesia in aged patients undergoing lower extremity surgery. Methods Forty elderly patients aged 63~92 years were randomly divided into two groups,Group EA received 2%lidocaine with epidural anesthesia, Group CSEA received 0.375% bupivacaine with spinal anesthesia.The anesthetic effects and side reactions were compared between the two groups. Results There were significant differences between EA group and CSEA group in the anesthetic start time and anesthetic level immovable time (P<0.01). CSEA was adequate for surgery in all patients and the incidence of hypotension was significantly lower in group CSEA than that in group EA(P<0.05). Conclusion Light specific gravity bupivacaine used in CSEA is safe and effective for aged patients.