CAJ | 학술논문

目的观察高龄患者髋关节手术小剂量罗哌卡因腰-硬联合麻醉的麻醉效果及对循环呼吸功能的影响.方法 ASA Ⅱ或Ⅲ级髋关节手术60例,男18例,女42例,年龄(85.5±10.5)岁,体重(65.35±13.91)kg,随机分为两组,各组30例.A组腰麻用轻比重0.2%罗哌卡因5～7 mg,硬膜外阻滞用0.2%罗哌卡因;B组腰麻用重比重0.5%布比卡因8～10 mg,硬膜外阻滞用0.375%布比卡因硬膜外阻滞.记录两组麻醉效果和术中BP、HR、SpO2变化.结果 A组麻醉平面T8～T10,单侧,术中各时点BP、HR、SpO2平稳,Bromage评分患肢1～2分,健肢0～1分;B组麻醉平面T6～T8,双侧,术中各时点BP明显下降,HR明显减慢(P<0.01),也低于A组(P<0.05),Bromage评分双下肢以3～4分为主.结论轻比重罗哌卡因腰-硬联合麻醉更适用于高龄髋关节手术患者.
목적 관찰고령환자관관절수술소제량라고잡인요-경연합마취적마취효과급대순배호흡공능적영향.방법 ASA Ⅱ혹Ⅲ급관관절수술60례,남18례,녀42례,년령(85.5±10.5)세,체중(65.35±13.91)kg,수궤분위량조,각조30례.A조요마용경비중0.2%라고잡인5～7 mg,경막외조체용0.2%라고잡인;B조요마용중비중0.5%포비잡인8～10 mg,경막외조체용0.375%포비잡인경막외조체.기록량조마취효과화술중BP、HR、SpO2변화.결과 A조마취평면T8～T10,단측,술중각시점BP、HR、SpO2평은,Bromage평분환지1～2분,건지0～1분;B조마취평면T6～T8,쌍측,술중각시점BP명현하강,HR명현감만(P<0.01),야저우A조(P<0.05),Bromage평분쌍하지이3～4분위주.결론 경비중라고잡인요-경연합마취경괄용우고령관관절수술환자.
Objective To observe the effects of the combined spinal-epidural anesthesia(CSEA) with small dose of ropivacaine on the circulatory and respiratory function in aged patients undergoing hip arthroplasty surgery. Methods Sixty ASA class Ⅱ or Ⅲ patients with aged 75 to 96 years old and weighted 57 to 79 kg were divided into two groups with 30 cases each. In group A,0.2% ropivacaine 5-7 mg was given for spinal block and 0.2% ropivacaine for epidural block, which were 0.5% bupivacaine 8-10 mg and 0. 375% bupivacaine, respectively, in group B. The anesthetic efficacy, BP, HR, SpO2, Bromage score were recorded. Results The analgesic plane was T8 10 in group A and T6-8 in group B. The changes of BP, HR, SpO2 were less in group A than those in group B. Bromage scores of group A were 1-2 for nonoperative extremity and 0-1 for the operative extremity, which were 3-4 for two extremities in group B. Conclusion The CSEA with 0. 2% ropivacaine 5-7 mg for spinal block and 0.2% ropivacaine for epidural block is suitable in aged patients undergoing hip arthroplasty surgery.