CAJ | 학술논문

目的评价腰丛神经阻滞用于老年患者单侧股动脉-股深动脉人工血管旁路术的可行性.方法择期行单侧股动脉-股深动脉人工血管旁路术患者40例,年龄67 ～ 81岁,体重47～65 kg,ASA分级Ⅱ级或Ⅲ级,采用随机数字表法,将其分为2组(n=20):脊麻组(S组)和腰丛神经阻滞组(L组).S组蛛网膜下腔注射0.5％重比重罗哌卡因3ml;L组在神经刺激仪引导下行腰丛神经阻滞,注射0.5％罗哌卡因30 ml.记录感觉阻滞起效时间、维持时间及麻醉效果,记录术中麻黄碱使用情况、输液量及腰丛神经阻滞相关不良事件发生情况.结果与S组比较,L组感觉阻滞起效时间和维持时间延长,麻黄碱使用率和输液量降低(P＜0.05),麻醉效果差异无统计学意义(P＞0.05).L组未见腰从神经阻滞相关不良事件.结论腰丛神经阻滞用于老年患者单侧股动脉-股深动脉人工血管旁路术是可行的.
목적 평개요총신경조체용우노년환자단측고동맥-고심동맥인공혈관방로술적가행성.방법 택기행단측고동맥-고심동맥인공혈관방로술환자40례,년령67 ～ 81세,체중47～65 kg,ASA분급Ⅱ급혹Ⅲ급,채용수궤수자표법,장기분위2조(n=20):척마조(S조)화요총신경조체조(L조).S조주망막하강주사0.5％중비중라고잡인3ml;L조재신경자격의인도하행요총신경조체,주사0.5％라고잡인30 ml.기록감각조체기효시간、유지시간급마취효과,기록술중마황감사용정황、수액량급요총신경조체상관불량사건발생정황.결과 여S조비교,L조감각조체기효시간화유지시간연장,마황감사용솔화수액량강저(P＜0.05),마취효과차이무통계학의의(P＞0.05).L조미견요종신경조체상관불량사건.결론 요총신경조체용우노년환자단측고동맥-고심동맥인공혈관방로술시가행적.
Objective To evaluate the feasibility of using lumbar plexus block for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.Methods Forty ASA physical status Ⅱ or Ⅲ patients,aged 67-81 yr,weighing 47-65 kg,scheduled for extremity artificial vascular graft between femoral artery and deep femoral artery,were randomly divided into 2 groups (n =20 each) using a random number table:spinal anesthesia group (group S) and lumbar plexus block group (group L).In group S,0.5 ％ hyperbaric ropivacaine 3 ml was injected into the subarachnoid space.In group L,lumbar plexus block was performed with 30 ml of 0.5 ％ ropivacaine under the guidance of a nerve stimulator.The onset time and duration of sensory block,anesthetic efficacy,and requirement for ephedrine and volume of fluid infused during operation,and development of lumbar plexus block-related adverse events were recorded.Results Compared with group S,the onset time and duration of sensory block were significantly prolonged,the requirement for ephedrine and volume of fluid infused during operation were decreased,and no significant change was found in anesthetic efficacy in group L.No lumbar plexus block-related adverse events developed in group L.Conclusion Lumbar plexus block can be used for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.