低浓度罗哌卡因腰麻在老年患者下肢骨科手术中的应用效果

摘要

OBJECTIVE:To investigate the application effects of low concentration ropivacaine lumbar anesthesia in elderly patients with lower limb surgery .METHODS: 150 elderly patients with lower limb surgery admitted into Jiangmen Xinhui People's Hospital from Jan.2013 to Jan.2015 were selected to be divided into group A and B via the random number table , with 75 cases in each .Group A were treated with 0.375% ropivacaine 2 ml; while group B received 0.5%ropivacaine 2 ml.Before anesthesia , and after anesthesia of 5 min, 15 min, 60 min, systolic pressure ( SBP) , mean arterial pressure ( MAP ) , heart rate ( HR ) and other hemodynamic indicators in two groups were observed , modified Bromage score was used to evaluate degree of motor nerve block , sensory block onset time and the complication rate were recorded .RESULTS: Compared with before anesthesia , there was no significant difference in SBP, MAP and HR of group A after anesthesia of 5 min, 15 min, 60 min (P>0.05).The SBP, MAP and HR of group B after anesthesia of 5 min were significantly lower than those before the anesthesia , with statistically significant difference ( P0.05).The complication rate of group A was 10.67%(8/75), significantly lower than that of group B [30.67%( 23/75 )], with statistically significant difference ( P <0.05 ).CONCLUSIONS: Low concentration ropivacaine continuous lumbar anesthesia can effectively maintain patients'hemodynamic stability , the anesthetic effects are satisfactory and the complication rate is low .It is worthy of clinical application and promotion .%目的：探讨低浓度罗哌卡因腰麻在老年患者下肢骨科手术中的应用效果。方法：选取2013年1月—2015年1月江门市新会区人民医院收治的行下肢骨科手术的老年患者150例作为研究对象，以随机数字表法分为A组与B组各75例。 A组患者给予0.375％罗哌卡因2 ml；B组患者给予0.5％罗哌卡因2 ml。观察2组患者麻醉前、麻醉5、15、60 min后的收缩压（SBP）、平均动脉压（ MAP）、心率（ HR）等血流动力学指标，观察运动神经阻滞程度、阻滞起效时间、并发症发生情况。结果：与麻醉前比较，A组患者麻醉5、15、60 min后SBP、MAP及HR均无统计学意义（P＞0.05），B组患者麻醉5 min后SBP、MAP及HR均明显低于麻醉前，差异有统计学意义（P＜0.05）；2组患者感觉阻滞起效时间与Bromage评分的差异无统计学意义（P＞0.05）；A组患者并发症发生率为10.67％（8／75），明显低于B组的30.67％（23／75），差异有统计学意义（P＜0.05）。结论：低浓度罗哌卡因腰麻在老年患者下肢骨科手术中能有效维持患者血流动力学稳定，麻醉效果较好，并发症发生率较低，值得推广。