轻比重布比卡因脊麻应用于老年前列腺电切术中的临床观察

目的评价老年前列腺电切术患者应用轻比重布比卡因脊麻的可行性。方法选择45例70岁以上择期行前列腺电切术的患者,并随机分为3组（n=15）,脊麻用药Ⅰ组为重比重布比卡因15mg（0.75%布比卡因原液2ml＋10%葡萄糖0.5ml）,Ⅱ组等比重布比卡因10mg（0.5%布比卡因原液2ml）,Ⅲ组轻比重布比卡因5mg（0.5%布比卡因原液1ml＋4ml注射用水或0.9%氯化钠溶液）。术中持续监测心电图、血压、心率、氧饱和度,观察临床麻醉效果及对循环系统的影响。结果所有患者均在脊麻下完成手术。给药后Ⅰ组、Ⅱ组中部分患者出现血压下降,需加快输液并给予麻黄碱纠正;Ⅲ组患者血液循环稳定,麻醉效果满意。结论老年前列腺电切术患者应用轻比重布比卡因脊麻,对循环系统影响小,是一种安全有效的麻醉方法。

Clinical Observation of Spinal Anesthesia with Hypobaric Bupivacaine in Elderly Patients Undergoing Electric Prostatectomy

Objective To explore the feasibility of using spinal anesthesia with hypobaric bupivacaine in elderly patients undergoing electric prostatectomy.Methods Forty-five ASAⅡ-Ⅲ patients aged 70 - 93yr were studied and randomly divided into three groups（n =15 for each group）：group Ⅰreceived spinal anesthesia with hyperbaric bupivacaine 15 mg ;group Ⅱ received spinal anesthesia with isobaric bupivacaine 10 mg ;group Ⅲ received spinal anesthesia with hypobaric bupivacaine 5 mg.In three groups spinal anesthesia was performed at L2 - 3 or L3 - 4.DBP、SBP、SpO2、HR、ECG at 5 min,10 min,15 min,30 min,60 min after bupivacaine was administered subarachnoidly were observed and recorded.Results In groupⅢ all the hemodynamics measurements were normal and there was no significant variation in BP and HR after spinal anesthesia（P〉 0.05）.Conclusion Spinal anesthesia with hypobaric bupivacaine can be safely used in elderly patients undergoing electric prostatectomy and may be good to the elderly patients with cardiovascular complication.