单侧腰硬联合阻滞在老年髋关节手术中的临床应用

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1、单侧腰硬联合阻滞在老年髋关节手术中的临床应用【摘要】0的研究小剂量低浓度轻比重布比卡因单侧腰硬联合阻滞在老年髋关节手术中的麻醉效果及围手术期麻醉不良反应。方法选择拟行髋关节手术的80例患者，ASAI〜II级，随机均分为0.375%布比卡因2.0ml轻比重组和0.375%布比卡因2.0ml等比重组，每组40例。分别评定两组麻醉效果及围手术期麻醉不良反应发生率。结果两组患者麻醉效果均满意，感觉、运动阻滞起效时间及感觉、运动阻滞消退时间差异无统计学意义（P>0.05）。轻比重组围手术期总不良反应发生率明显低于等比重组，差异有统计学意义（P〈0.05）。结论小剂量低浓度轻比重布比卡因单侧腰硬

2、联合阻滞在老年患者髋关节手术屮麻醉效果满意，血流动力学更加平稳，围手术期麻醉不良反应少，是一种比较安全可靠的麻醉方法。【关键词】布比卡因；单侧腰硬联合阻滞；老年；髋关节手术中图分类号：R687.4;R614.4文献标识码：AD0I:10.3969/j.issn.10031383.2017.01.018AstudyonclinicapplicationofunilateralcombinedspinalepiduralanesthesiaonhipjointsurgeryforelderlypatientsMENGShaoguang,M0Shaoping，LUMcixiang(Depa

3、rtmentofAnesthesology，BinyangHospitalofTraditionalChineseMedicine,Binyang530400,China)[HJ2][HJ][Abstract]ObjectiveTostudyanestheticeffectandadversereactionsofunilateralcombinedspinalepiduralanesthesiaonhipjointsurgeryforelderlypatientswithsmalldoseandlowconcentrationhypobaricbupivacaine.Methods

4、80ASAIorASAIIpatientswhoplanedtoundergohipjointsurgerywereselected,theywererandomlydividedintohypobaricgroup(2.0mlofbupivacainewith0.375%)andisobaricgroup(2.0mlofbupivacainewith0.375%)with40casesineachgroup.Anestheticeffectsandtheincidentrateofadversereactionsduringperioperativeperiodwerecompar

5、edbetweenthetwogroups.ResultsTheanestheticeffectsofthetwogroupswerebothobvious.Differenceoftheonsettimeofsensoryandmotornerveblockbetweenthetwogroupswasnotstatisticallysignificant,sowasthedisappearingtime(P>0.05).Totalincidentrateofadversereactionsoftheisobaricgroupduringthepreoperativeperiodwa

6、ssignificantlylowerthanthatofthehypobaricgroup,sodifferencewasstatisticallysignificant(P〈0.05).ConelusionUnilateralcombinedspinalepiduralanesthesiawithsmalldoseoflowconcentrationhypobaricbupivacaineonhipjointsurgeryforelderlypatientshassatisfiedanesthesiaeffects,preoperativeperiod.Itisasafeandr

7、eliableanestheticmethod.［Keywords］bupivacaine；unilateralcombinedspinalepiduralanesthesia;elderlypatients；hipjointsurgery?S着医学的发展和我国社会人门老龄化加速，老年患者全髋置换术及股骨头置换术逐年增多［1］。老年患者由于身体机能生理性退化，各脏器功能较脆弱，部分患者常合并内科基础疾病，增加了围手术期风险，麻醉不良反应发生率较高［2］。选