舒芬太尼复合小剂量布比卡因蛛网膜下腔麻醉在老年患者手术中的应用

目的观察舒芬太尼复合小剂量布比卡因蛛网膜下腔注射在老年患者麻醉中的临床效果。方法 60例择期行下腹部或下肢手术患者,随机分为三组,每组20例。Ⅰ组:0.5%布比卡因7.5mg+舒芬太尼5μg,Ⅱ组:0.5%布比卡因7.5mg+舒芬太尼2.5μg,Ⅲ组:0.5%布比卡因10mg行蛛网膜下腔麻醉。观察感觉阻滞起效时间、感觉阻滞平面上界、镇痛维持时间、运动阻滞起效时间、运动阻滞程度、血流动力学影响及不良反应发生情况。结果Ⅰ、Ⅱ组给药后血流动力学影响小,运动阻滞恢复时间短于Ⅲ组,恶心、头晕发生率明显低于Ⅲ组(P<0.05);Ⅰ组感觉阻滞起效时间,达T10时间明显短于Ⅱ组和Ⅲ组,T10镇痛维持时间明显长于Ⅱ组和Ⅲ组(P<0.05)。结论舒芬太尼2.5、5μg复合小剂量布比卡因蛛网膜下腔注射用于老年患者均可产生良好的感觉和运动阻滞,且对血流动力学影响小。

The application of sufentanil combined with low-dose bupivacaine for spinal an~thesia in elderly patients

Objective To investigate the effect of spinal anesthesia with different doses of sufentanil combined with low-dose bupivacaine in elderly patients. Methods Sixty patients undergoing abdominal or leg surgery were randomly divided into three groups with 20 cases each, all patients were received spinal anesthesia. Group Ⅰ:0.5% bupivacaine 7.5 mg+sufentanil 5 μg; group Ⅱ: 0.5% bupivacaine 7.5 mg + sufentanil 2.5 μg; group Ⅲ: 0.5% bupivacaine 10 mg. The onset time of sensory and motor block, the upper sensory block level, post-operative analgesia, the degree of motor block, hemodynamics and side effects were recorded. Results In groupⅠand Ⅱ the hemodynamics were more stable, the time of regression motor block were faster and nausea and dizziness were lower than that in group Ⅲ(P<0.05). In groupⅠ the onset time of sensory block, reaching to the T10 dermatomes of time were shorter, and post-operative analgesia was longer than in groups Ⅱ, Ⅲ (P<0.05).Conclusion Sufentanil combined with low-dose bupivacaine for spinal anesthesia in elderly patients can provide adequate sensory and motor block without hemodynamic instability.