CAJ | 학술논문

目的研究小剂量布比卡因复合芬太尼腰硬联合麻醉应用于高龄患者的可行性.方法选择拟行下腹部及下肢手术的高龄患者共60例,采用完全随机法分为2组:小剂最布比卡因复合芬太尼试验组(S组,n=30)及单纯布比卡因对照组(C组,n=30),评价两组的阻滞效果,观察两组低血压,心律失常,恶心、呕吐,寒战的发生率以及治疗低血压的麻黄碱应用.结果两组患者均可产生可靠的麻醉效果,S组术中低血压发生率为13.3%,显著低于对照组(26.7%);试验组心律失常的发生率为16.7%显著低于对照组(43.3%),试验组与对照组相比,低血压需要麻黄素十预的患者例数显著减少;试验组恶心、呕吐的发生率显著低于对照组.两组寒战反应的发生率均较低,差异无统计学意义.结论在实施卜腹部和下肢手术的高龄患者,小剂量布比卡因复合芬太尼腰硬联合麻醉可保持心血管系统稳定,并可减少恶心、呕吐等副作用的发生.
목적 연구소제량포비잡인복합분태니요경연합마취응용우고령환자적가행성.방법 선택의행하복부급하지수술적고령환자공60례,채용완전수궤법분위2조:소제최포비잡인복합분태니시험조(S조,n=30)급단순포비잡인대조조(C조,n=30),평개량조적조체효과,관찰량조저혈압,심률실상,악심、구토,한전적발생솔이급치료저혈압적마황감응용.결과 량조환자균가산생가고적마취효과,S조술중저혈압발생솔위13.3%,현저저우대조조(26.7%);시험조심률실상적발생솔위16.7%현저저우대조조(43.3%),시험조여대조조상비,저혈압수요마황소십예적환자례수현저감소;시험조악심、구토적발생솔현저저우대조조.량조한전반응적발생솔균교저,차이무통계학의의.결론 재실시복복부화하지수술적고령환자,소제량포비잡인복합분태니요경연합마취가보지심혈관계통은정,병가감소악심、구토등부작용적발생.
Objective To analyze the clinical feasibility of small-dose bupivacaine with fentanyl for combined spinal-epidural anesthesia in elderly patients. Methods Sixty elderly patients undergoing elective lower abdominal and lower limb surgery were randomized into two groups(n=30). The study group received spinal anesthesia with a combination of low-dose bupivacaine and fentanyl,while the control group received alone bupivacaine. The block effects were assessed. The incidences of hypotension, arrhythmia, nausea and vomiting, and shivering and use of ephedrine required for hypotension treatment were observed. Results All patients in two groups had adequate anesthetic effect The incidence of hypotension was 13.3% in Study Group that was significantly lower than in Control Group (26.7%) ;The occurrence of arrhythmia in Study Group (16.7%) was significantly lower than in Control Group (43.3%) ;The need of ephedrine due to hypotension was significantly less in Study Group;The number of patients using ephedrine due to hypotension was less in study group compared to the control group. The frequency of shivering was low in two groups , and there was no significant difference between them. Conclusion In elderly patients undergoing elective lower abdominal and lower limb surgery, small-dose bupivacaine with fentanyl for spinal-epidural block may maintain the cardiovascular stability and reduce the incidences of side-effects such as nausea and vomiting.