中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
35期
32-34
,共3页
左布比卡因%蛛网膜下隙阻滞%高密度%老年人%下肢手术
左佈比卡因%蛛網膜下隙阻滯%高密度%老年人%下肢手術
좌포비잡인%주망막하극조체%고밀도%노년인%하지수술
Levobupivacaine%Spinal anesthesia%Hyperbaric%Aged%Lower extremity operation
目的 观察高密度小剂量左布比卡因单侧蛛网膜下隙阻滞用于老年患者下肢骨科手术的临床效果和可行性.方法 选择择期行下肢骨科手术的老年患者756例,按照随机数字表法分为左布比卡因组383例和布比卡因组373例.观察两组麻醉前后血流动力学变化、感觉和运动阻滞的情况.结果 左布比卡因组感觉阻滞起效时间和运动阻滞起效时间分别为(5.9±1.4)、(11.7±3.0) min,均明显晚于布比卡因组的(4.2±0.3)、(9.1±3.3) min,差异有统计学意义(P＜0.05)；而左布比卡因组运动阻滞持续时间为(152.8±17.5) min,明显短于布比卡因组的(195.4±18.7) min,差异有统计学意义(P＜0.05)；左布比卡因组最高运动阻滞评分为(1.1±0.3)分,明显低于布比卡因组的(2.3±0.6)分,差异有统计学意义(P＜0.05).两组最高感觉阻滞平面和血流动力学变化比较差异无统计学意义(P＞0.05).结论 左布比卡因麻醉效果虽略逊于布比卡因,但高密度小剂量左布比卡因单侧蛛网膜下隙阻滞因其麻醉效果确切、血流动力学稳定、感觉和运动阻滞恢复快,用于老年患者下肢骨科手术更为安全.
目的 觀察高密度小劑量左佈比卡因單側蛛網膜下隙阻滯用于老年患者下肢骨科手術的臨床效果和可行性.方法 選擇擇期行下肢骨科手術的老年患者756例,按照隨機數字錶法分為左佈比卡因組383例和佈比卡因組373例.觀察兩組痳醉前後血流動力學變化、感覺和運動阻滯的情況.結果 左佈比卡因組感覺阻滯起效時間和運動阻滯起效時間分彆為(5.9±1.4)、(11.7±3.0) min,均明顯晚于佈比卡因組的(4.2±0.3)、(9.1±3.3) min,差異有統計學意義(P＜0.05)；而左佈比卡因組運動阻滯持續時間為(152.8±17.5) min,明顯短于佈比卡因組的(195.4±18.7) min,差異有統計學意義(P＜0.05)；左佈比卡因組最高運動阻滯評分為(1.1±0.3)分,明顯低于佈比卡因組的(2.3±0.6)分,差異有統計學意義(P＜0.05).兩組最高感覺阻滯平麵和血流動力學變化比較差異無統計學意義(P＞0.05).結論 左佈比卡因痳醉效果雖略遜于佈比卡因,但高密度小劑量左佈比卡因單側蛛網膜下隙阻滯因其痳醉效果確切、血流動力學穩定、感覺和運動阻滯恢複快,用于老年患者下肢骨科手術更為安全.
목적 관찰고밀도소제량좌포비잡인단측주망막하극조체용우노년환자하지골과수술적림상효과화가행성.방법 선택택기행하지골과수술적노년환자756례,안조수궤수자표법분위좌포비잡인조383례화포비잡인조373례.관찰량조마취전후혈류동역학변화、감각화운동조체적정황.결과 좌포비잡인조감각조체기효시간화운동조체기효시간분별위(5.9±1.4)、(11.7±3.0) min,균명현만우포비잡인조적(4.2±0.3)、(9.1±3.3) min,차이유통계학의의(P＜0.05)；이좌포비잡인조운동조체지속시간위(152.8±17.5) min,명현단우포비잡인조적(195.4±18.7) min,차이유통계학의의(P＜0.05)；좌포비잡인조최고운동조체평분위(1.1±0.3)분,명현저우포비잡인조적(2.3±0.6)분,차이유통계학의의(P＜0.05).량조최고감각조체평면화혈류동역학변화비교차이무통계학의의(P＞0.05).결론 좌포비잡인마취효과수략손우포비잡인,단고밀도소제량좌포비잡인단측주망막하극조체인기마취효과학절、혈류동역학은정、감각화운동조체회복쾌,용우노년환자하지골과수술경위안전.
Objective To explore the effects and feasibility of minimal local analgesic dose of hyperbaric levobupivacaine in elderly patients undergoing unilateral spinal anesthesia during lower limb orthopedic surgery.Methods Seven hundred and fifty-six elderly patients who scheduled lower limb orthopedic surgery were assigned to levobupivacaine group (383 patients) and bupivacaine group (373 patients) by random digits table method.Haemodynamic change were monitored before,during and after anesthesia.The level and duration of sensory and motor block in each group were evaluated.Results Compared with bupivacaine group,the sensory block and motor block onset time was significantly longer in levobupivacaine group [(5.9 ± 1.4) min vs.(4.2 ± 0.3) min,(11.7 ± 3.0) min vs.(9.1 ± 3.3) min] (P ＜0.05),but the motor block duration was shorter [(152.8 ± 17.5) min vs.(195.4 ± 18.7) min] (P ＜ 0.05).The scores of maximum motor block in levobupivacaine group was significantly lower than that in bupivacaine group[(1.1 ±0.3) min vs.(2.3 ±0.6) min](P＜ 0.05).There was no significant difference in peak sensory block and haemodynamic between two groups (P ＞ 0.05).Conclusions Although levobupivacaine may be less potent than bupivacaine,it may be preferred for elderly patients with lower limb surgery because of satisfactory spinal anesthesia,good hsemodynamic stability and fast motor block regression.
