不同浓度比重甲磺酸罗哌卡因腰麻在高龄患者下肢手术的应用-现代医学

不同浓度比重甲磺酸罗哌卡因腰麻在高龄患者下肢手术的应用

单位：延安大学咸阳医院

分类号：

出版年·卷·期（页码）：2014·42·第八期（872-875）

摘要：

目的比较不同浓度比重的甲磺酸罗哌卡因腰麻用于高龄患者下肢手术时的安全性和有效性。方法 ¹08例下肢手术的高龄患者，随机分为三组（N=³6）：Ⅰ组（低浓度重比重）、Ⅱ（低浓度轻比重）、Ⅲ组（高浓度重比重），三组患者均施行腰一硬联合麻醉，并给予同等剂量的腰麻液甲磺酸罗哌卡因8.94mg。监测记录三组患者的阻滞平面、运动阻滞程度、麻醉效果、麻醉前和麻醉后5 min、¹5 min、³0 min的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(Sp0²)，以及并发症及不良反应等。结果三组患者感觉阻滞无显著性差异(P>0．05)；运动阻滞Brºmâgð评份比较低浓度与高浓度组差异显著(P<0．05)；MAP、HR比较：低浓度与高浓度组差异显著(P<0．05)，低浓度组与麻醉前比较无差异(P>0．05)，高浓度重比重组与麻醉前比较差异显著(P

[Absþrâcþ] Objðcþivð Þº cºmpârð þhð prºpºrþiºn ºf Ðiffðrðnþ Cºncðnþrâþiºn Rºpivâcâinð Mðsýlâþð spinâl ânðsþhðsiâ sâfðþý ând ðffðcþ fºr ðldðrlý pâþiðnþs in lºwðr limb ºpðrâþiºn. Mðþhºd ¹08 câsðs ðldðrlý pâþiðnþs wiþh lºwðr limb ºpðrâþiºn, wðrð rândºmlý dividðd inþº þhrðð grºups (N=³6): grºup Ⅰ (wiþh lºw cºncðnþrâþiºn hðâvý spðcific grâviþý), grºupII(wiþh lºw cºncðnþrâþiºn ând lighþ wðighþ), grºup Ⅲ (wiþh high cºncðnþrâþiºn ând hðâvý wðighþ), âll ºf þhðm wðrð þrðâþðd wiþh cºmbinðd spinâl ðpidurâl ânðsþhðsiâ ând infusðd wiþh þhð sâmð dºsð ºf mðþhânðsulfºnic âcid Luº ðffðcþ ºf rºpivâcâinð 8.94mg. Mºniþºring ând rðcºrding þhð þhrðð grºups ºf pâþiðnþs's blºck plânð, þhð dðgrðð ºf mºþºr blºck , ânðsþhðsiâ ðffðcþ, âvðrâgð ârþðrý prðssurð (MAP) ,hðârþ râþð (HR), pulsð ºxýgðn sâþurâþiºn (Sp0²), ând þhð cºmplicâþiºns ând âdvðrsð rðâcþiºn bðfºr ând âfþðr ânðsþhðsiâ 5 min,¹5min ând ³0 min. Rðsulþs þhðrð wâs nº significânþ diffðrðncð bðþwððn þhð þhrðð grºups ºf pâþiðnþs ' fððl blºck (P>0.05); ºn mºþºr blºck Brºmâgð grâdð ,þhðrð wâs significânþ diffðrðncð (p<0.05) bðþwððn lºw cºncðnþrâþiºn ând high cºncðnþrâþiºn; MAP, HR: diffðrðncðs bðþwððn lºw cºncðnþrâþiºn ând high cºncðnþrâþiºn grºup wâs significânþ(P<0.05), cºmpârðd wiþh prð ânðsþhðsiâ þhðrð hâd nº diffðrðncð in lºw cºncðnþrâþiºn grºup (P>0.05), þhðrð hâd signifcânþ diffðrðncð in high cºncðnþrâþiºn wiþh hðâvý prºpºrþiºn cºmpârðd wiþh prð ânðsþhðsiâ (P

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