【摘要】 目的探讨舒芬太尼复合布比卡因用于老年患者腰麻引起呼吸抑制的半数有效剂量。方法择期行经尿道前列腺切除术老年患者30例,ASAⅡ～Ⅲ级,年龄65～90岁,选择L_3-4间隙穿刺。第1例蛛网膜下腔注入舒芬太尼5.0μg+布比卡因7.5 mg（0.25%）,其后各患者的舒芬太尼剂量按序贯法确定,如果上一例患者出现呼吸抑制则下降一个剂量梯度,未出现呼吸抑制则上升一个剂量梯度,剂量变化梯度为1.1。根据呼吸频率、呼吸暂停时间、脉搏血氧饱和度、呼气末二氧化碳分压分析判定有无呼吸抑制。结果舒芬太尼复合布比卡因用于老年患者腰麻引起呼吸抑制的半数有效剂量为5.92μg,95%可信区间为5.63～6.22μg。,结论舒芬太尼复合布比卡因用于老年患者腰麻引起呼吸抑制的半数有效剂量为5.92μg。更多还原

【Abstract】 AIM To investigate the respiratory depression half-effective dose of sufentanil-bupivacaine in subarachnoid anaesthesia of elderly patients.METHODS Thirty ASA（American Society of Anesthesiologists）ⅡorⅢelderly patients aged 65-90 years[（76.9±7.2）years]prepared transurethral resection of prostate（TURP）.Subarachnoid anesthesia was performed at L_3-4interspace.The initial dose of intrathecal sufentanil in the first patient was 5.0μg and bupivacaine was 7.5 mg（0.25%）.If effect was satisfied,the next patient received a lower dose of sufentanil;conversely if ineffective the next patient received a higher dose of sufentanil.The respiratory depressant half-effective dose was determined by up-and-down sequential experiment according to Dixon-Massey method.The ratio of two successive sufentanil dose was 1.1.Respiratory depression was defined as respiration rate（RR）≤8 bpm or（and）apnea≥15 s or（and）SpO₂≤94%or（and）P_etCO₂≥55 mm Hg.RESULTS The respiratory depression half-effective dose of sufentanil-bupivacaine in elderly patients’subarachnoid anesthesia was 5.92μg,（95%confidence interval was 5.63-6.22μg）.CONCLUSION The respiratory depression half-effective dose of sufentanil-bupivacaine in elderly patients’ subarachnoid anesthesia is 5.92μg.更多还原