CAJ | 학술논문

目的探讨0.75%速卡(左旋布比卡因)腰硬联合麻醉在老年患者全髋置换术中的临床麻醉效果和可行性.方法 60例老年全髋置换术患者随机分为两组,每组30例.B组使用0.75%布比卡因,L组使用0.75%左旋布比卡因,两组均行腰硬联合麻醉(CSEA),鞘内各注入15 mg.术中必要时经硬膜外导管注入1.5%利多卡因.术中监测BP、HR、SpO2、R的变化并观察感觉阻滞起效时间、最高感觉阻滞平而、达最高感觉阻滞平面时间、运动阻滞评分以及围术期不良反应的发生.结果两组感觉阻滞起效时间差异无显著性(P>0.05);最高感觉阻滞平面L组略低于B组,但差异无显著性;达最高感觉阻滞平面时间L组略短于B组,但无显著性差异;两组患者运动阻滞评分差异无显著性;两组均无神经系统的不良反应.结论 0.75%速卡(左旋布比卡因)腰硬联合麻醉用于老年患者全髋置换术中对血流动力学影响小,其临床麻醉效果是安全可行的.
목적 탐토0.75%속잡(좌선포비잡인)요경연합마취재노년환자전관치환술중적림상마취효과화가행성.방법 60례노년전관치환술환자수궤분위량조,매조30례.B조사용0.75%포비잡인,L조사용0.75%좌선포비잡인,량조균행요경연합마취(CSEA),초내각주입15 mg.술중필요시경경막외도관주입1.5%리다잡인.술중감측BP、HR、SpO2、R적변화병관찰감각조체기효시간、최고감각조체평이、체최고감각조체평면시간、운동조체평분이급위술기불량반응적발생.결과 량조감각조체기효시간차이무현저성(P>0.05);최고감각조체평면L조략저우B조,단차이무현저성;체최고감각조체평면시간L조략단우B조,단무현저성차이;량조환자운동조체평분차이무현저성;량조균무신경계통적불량반응.결론 0.75%속잡(좌선포비잡인)요경연합마취용우노년환자전관치환술중대혈류동역학영향소,기림상마취효과시안전가행적.
Objective To evaluate the efficacy and safety of 0.75% levobupivacaine for combined spi-nal and epidural anesthesia (CSEA) in old patients undergoing total hip replacement surgery. Methods Sixty ASA Ⅰ～Ⅱ patients, scheduled for selective total hip replacement surgery, were randomly divided into two groups. The patients in group L, received 0.75% levobupivaeaine 15 nag(2 ml)for spinal anesthesia, and those in group B, received same amount of 0.75 % bupivacane. 2% lidocaine was supplemented via epidural catheter when spinal analgesia was inadequate. During operation, BP, HR and SpO2 were monitored continually. Sensory and motor blockade, side effects were recorded. Results The plane of block, onset time, duration of blockade, motor block were comparable between two groups. There was no neural side effects in both groups. Conclusion 0.75% levobupivacaine for CSEA is effective and safe for total hip replacement surgery.