CAJ | 학술논문

目的：探讨不同腰麻用药对高龄骨科手术患者的麻醉效果。方法：2012年2月-2013年12月收治骨科手术老年患者180例，随机分成观察组和对照组各90例。所有患者均侧卧位，穿刺点选择 L3～4椎间隙，对照组腰麻注药0.75%布比卡因1.5ml，注药时间20秒，然后水平仰卧。观察组腰麻注药复合芬太尼5μg，罗哌卡因1.5ml，注药时间20秒，然后水平仰卧。结果：观察组感觉阻滞起效时间(34.4±8.5)秒，痛觉阻滞起效时间(169.1±28.5)秒，运动阻滞起效时间(168.1±2.4)秒，运动恢复时间(148.5±25.8)秒。对照组感觉阻滞起效时间(33.9±6.6)秒，痛觉阻滞起效时间(172.2±23.6)秒，运动阻滞起效时间(171.2±2.5)秒，运动恢复时间(145.9±24.5)秒。两组麻醉效果比较无统计学意义(P＞0.05)。观察组发生不良反应5例(5.6%)，其中恶心、呕吐2例，心动过缓2例，低血压1例。对照组发生不良反应34例(37.8%)，其中恶心、呕吐10例，心动过缓10例，低血压14例，两组比较差异有统计学意义(P＜0.05)。结论：罗哌卡因复合芬太尼具有麻醉效果好，并发症少，可作为高龄骨科手术麻醉的首选药物。
목적：탐토불동요마용약대고령골과수술환자적마취효과。방법：2012년2월-2013년12월수치골과수술노년환자180례，수궤분성관찰조화대조조각90례。소유환자균측와위，천자점선택 L3～4추간극，대조조요마주약0.75%포비잡인1.5ml，주약시간20초，연후수평앙와。관찰조요마주약복합분태니5μg，라고잡인1.5ml，주약시간20초，연후수평앙와。결과：관찰조감각조체기효시간(34.4±8.5)초，통각조체기효시간(169.1±28.5)초，운동조체기효시간(168.1±2.4)초，운동회복시간(148.5±25.8)초。대조조감각조체기효시간(33.9±6.6)초，통각조체기효시간(172.2±23.6)초，운동조체기효시간(171.2±2.5)초，운동회복시간(145.9±24.5)초。량조마취효과비교무통계학의의(P＞0.05)。관찰조발생불량반응5례(5.6%)，기중악심、구토2례，심동과완2례，저혈압1례。대조조발생불량반응34례(37.8%)，기중악심、구토10례，심동과완10례，저혈압14례，량조비교차이유통계학의의(P＜0.05)。결론：라고잡인복합분태니구유마취효과호，병발증소，가작위고령골과수술마취적수선약물。
Objective:To explore the anesthetic effect of different anesthetics for senile patients with department of orthopedics operation.Methods:180 elderly patients with department of orthopedics operation were selected from February 2012 to December 2013.They were randomly divided into the observation group and the control group with 90 cases in each.All patients took the lateral decubitus position,and the puncture point was L3~4 vertebra clearance.Narcotic drug of the control group was 0.75%bupivacaine 1.5ml,and the injection time was 20 seconds,then patients took horizontal supine.Narcotic drugs of the observation group were Fentanyl 5μg,ropivacaine 1.5ml,the injection time was 20 seconds,then patients took horizontal supine.Results:In the observation group,the onset time of sensory block was 34.4±8.5 seconds,the onset time of analgesia block was 169.1±28.5 seconds,motor block onset time was 168.1±2.4 seconds,motor recovery time was 148.5±25.8 seconds.In the control group,the onset time of sensory block was 33.9±6.6 seconds,the onset time of analgesia block was 172.2±23.6 seconds,motor block onset time was 171.2 ± 2.5 seconds,motor recovery time was 145.9 ± 24.5 seconds.The anesthesia effect of two group showed no statistical significance(P>0.05).In the observation group,5 cases(5.6%)occurred adverse reactions,including nausea and vomiting in 2 cases,bradycardia in 2 cases,1 case of hypotension.In the control group,34 cases(37.8%)occurred adverse reactions,including 10 cases of nausea and vomiting,bradycardia in 10 cases,14 cases with hypotension.There were statistically significant differences between the two groups(P<0.05).Conclusion:The anesthetic effect of ropivacaine combined with fentanyl is good,complications are few,and it can be used as the first drug for senile patients with department of orthopedics operation.