【摘要】 目的:探讨罗哌卡因复合舒芬太尼在老年患者腰硬联合麻醉中的临床效果。方法:将择期行股骨手术(股骨颈骨折、股骨干骨折及股骨远端骨折)的老年患者60例,按随机数字表法分为A,B,C 3组,分别给以0.5%罗哌卡因7.5 mg,0.5%罗哌卡因7.5 mg复合舒芬太尼5μg,0.5%罗哌卡因6 mg复合舒芬太尼5μg。比较3组麻醉效果、循环变化、运动阻滞程度及麻醉不良反应情况。结果:所有患者均成功实施腰硬联合麻醉,并顺利完成手术。与A,B 2组比较,C组的MAP,HR变化更平稳(P<0.05),其到达最高感觉阻滞平面的时间也优于前者,同时C组中痛觉退至T12时间和痛觉阻滞持续时间也明显优于其他2组,其中B组优于A组(P<0.01)。3组的VAS评分时间点差异有统计学意义(P<0.05),但组间、组间·时间点交互作用差异无统计学意义(P>0.05)。3组中C组无明显不良反应。结论:0.5%罗哌卡因6 mg复合舒芬太尼5μg腰硬联合麻醉在老年患者股骨骨折手术中,麻醉平稳,痛觉阻滞满意,无不良反应,同时可实施硬膜外术后镇痛,值得临床应用。更多还原

【Abstract】 Objective: To analyze the effect of small dose ropivacaine combined with sufentanil in combined spinal-epidural anesthesia for operation of elderly patients femoral fracture. Methods: 60 selected surgical elderly patients( femoral fracture) were randomly divided into three groups. Group A was treated with 0. 5% ropivacaine 7. 5 mg,Group B with 0. 5% ropivacaine 7. 5 mg + sufentanil5. 0 ug and Group C with 0. 5% ropivacaine 6. 0 mg + sufentanil 5. 0μg. Effects of anesthesia,changes of circulation,block extent of movement and adverse reactions were evaluated and compared among the three groups. Results: All the patients obtained successful operation results with combined spinal-epidural anesthesia. Group C obtained the most stable MAP and HR( P < 0. 05) compared with Groups A and B. Group C was better than groups A and B in average time to reach the highest sensory block levels. And Group C was absolutely superior to other groups in time retreating to T12 and in duration of sensory block( P < 0. 01). VAS among the three groups was of statistic significance( P < 0. 05) but the interaction of inter-group and inter-group time point showed no significant difference( P> 0. 05). There was no significant adverse effect in group C. Conclusion: 0. 5% ropivacaine 6 mg combined with sufentanil 5 ug used for combined spinal-epidural anesthesia in elderly patients of femoral fracture operation produced stable anaesthetic effect. The result of algesia block meets the satisfaction of patients. There are no obvious adverse reactions. It is worthy of clinical application.更多还原