Objective To observe the effect of unilateral spinal anesthesia with low dose light specific gravity bupivacaine in the elderly undergoing hip surgery.Methods Fifty elderly patients undergoing hip surgery under combined lumbar-epidural anesthesia were divided into two groups with 25 cases each.The light specific gravity unilateral spinal anesthesia in group A was performed with 1-1.5 ml of a mixture of 0.75％ bupivacaine 2 ml plus normal saline 1 ml.The heavy specific gravity spinal anesthesia in group B was performed with 1-1.5 ml of a mixture of 0.75％ bupivacaine 2 ml plus 10％ glucose 1 ml.The anesthetic efficiency and changes of BP and HR were compared between the two groups.Results The anesthetic effect of both groups was good.Unilateral block occurred in 16 cases and bilateral block occurred in 9 cases in group A.Bilateral block occurred in all 25 cases of group B.Anesthesia maintenance time was shorter in group A than that in group B [ (155.3±18.0) minutes vs. (220.3±15.1) minutes] (P＜0.05).Bromage score of group A was lower in group A than that in group B [ (2.9±0.3) points vs. (5.8±0.6) points] (P＜0.05).The amont of ephedrine used was less in group A than that in group B [ (5.4±2.8) mg vs. (11±3.3) mg] (P＜0.05).Conclusion Compared to heavy specific gravity spinal anesthesia, unilateral spinal anesthesia with low dose light specific gravity bupivacaine has the advantages of slight motor block and less effect on circulation in elderly patients undergoing hip surgery.%目的 观察小剂量轻比重布比卡因单侧腰麻在老年髋部手术患者的应用效果.方法 在腰-硬联合麻醉下行髋部手术老年患者50例分为两组,每组25例.轻比重组腰麻采用注入1～1.5 ml的0.75％布比卡因2 ml+注射用水1 ml混合液;重比重组注入1～1.5 ml的0.75％布比卡因2 ml+10％葡萄糖溶液1 ml混合液.比较两组的麻醉效果和BP、HR变化.结果 两组麻醉效果均良好.轻比重组单侧阻滞16例,双侧阻滞9例;重比重组25例均出现双侧阻滞.轻比重组的麻醉维持时间短于重比重组[(155.3±18.0)min vs.(220.3±15.1)min](P＜0.05),Bromage评分低于重比重组[(2.9±0.3)分vs.(5.8±0.6)分](P＜0.05).轻比重组麻黄碱使用总量少于重比重组[(5.4±2.8)mg vs.(11.0±3.3)mg](P＜0.05).结论 与重比重腰麻比较,小剂量轻比重布比卡因腰麻用于老年髋部手术患者时,运动阻滞较轻,循环影响较小.
展开▼
