【摘要】 【目的】探讨布比卡因混合舒芬太尼腰麻对前列腺电切术(transurethral resection of the prostate,TURP)老年患者心输出量的影响。【方法】60例ASAⅠ~Ⅲ级择期行TURP 60岁以上患者随机分为A,B,C组,每组20例。A组:布比卡因15 mg+10%葡萄糖溶液,B组:布比卡因7.5mg+舒芬太尼5μg+10%葡萄糖溶液;C组:布比卡因7.5 mg+舒芬太尼7.5μg+10%葡萄糖溶液;三者的容量均为3mL。通过阻抗心动描记法血流动力学监测仪(BioZ.com)分别于注药前1 min(T0)、注药后3 min(T1)、10 min(T2)3、0 min(T3)4个时点监测血流动力学,读取参数:心输出量(CO)、心率(HR)、心指数(CI)外周血管阻力指数(SVRI)。【结果】A组的CO,CI,SVRI在腰麻后10 min和30 min明显减少。B组和C组腰麻后3、10、30 min的CO,CI,SVRI明显高于A组(P<0.01),C组与B组比较,在腰麻后10 min的CO,CI相比较也有统计学意义(P<0.05)。【结论】小剂量布比卡因复合舒芬太尼腰麻对TURP老年患者血液动力学影响小,麻醉能增加外周阻力,心输出量增加,能避免腰麻对老年患者产生低血压的不良影响。更多还原

【Abstract】 【Objective】To explore the effect of low dose of sufentanil combined with bupivacaine administrated intrathecally on cardiac output of patients undergoing transurethral resection of the prostate(TURP).【Methods】 Sixty patients(ASAⅠ~Ⅲ) undergoing TURP were divided randomly into 3 groups(n=20),i.e.group A,group B and group C.Group A received 7.5mg bupivacaine + 5μg sufentanil +10% glucose.Group B received 7.5mg bupivacaine+7.5μg sufentanil +10% glucose.Group C received 15mg bupivacaine +10% glucose.The volume was 3mL in every group.Cardiac output(CO),cardiac index(CI),heart rate(HR) and systemic vascular resistance index(SVRI) were measured at 1 min before performance of spinal blockage and 3,10,and 30 min after intrathecal injection by hemodynamic monitoring equipment.【Results】 CO,CI and SVRI decreased at 10 and 30min in the group A compared with baseline value.CO,CI and SVRI were higher in group B and C as compared with group A from 3 min to 30 min after spinal anesthesia(P<0.01).Moreover CO,CI and SVRI were significantly decreased in group C than those in group B(P<0.05).【Conclusion】 Spinal anesthesia with low dose of sufentanil combined with bupivacaine provides successful anesthesia and gives better stability of CO than standard spinal bupivacaine in TURP does.更多还原