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1、腰丛一腰椎旁神经阻滞用于老年患者股骨头置换术的临床观察［摘耍］目的探讨神经刺激仪引导腰从-腰椎旁神经阻滞用于老年患者股骨头置换术的麻醉效果、安全性及术后镇痛药物用量。方法选取2008年12月〜2012年12月在北京航天总医院行股骨头置换术患者共62例(A组29例,男20例,女9例；B组33例,男21例,女12例)，A组(研究组)应用腰丛-腰椎旁神经阻滞复合丙泊酚［4〜6mg/(kg?h)］+芬太尼［0.0015〜0.0020mg/(kg?h)］静脉镇静，B组(对照组)应用单次蛛网膜下腔麻醉复合丙泊
2、酚［4〜6mg/(kg?h)］+芬太尼［0.0015〜0.0020mg/(kg?h)J静脉镇静;两组均用盐酸托烷司琼5吨+盐酸丁丙诺菲(0.015〜0.020mg/kg)复合液静脉术后镇痛，镇痛泵为驼人医疗器械集团生产的lOOmL自控泵。比较两组老年患者股骨头置换术的麻醉效果、安全性及术后镇痛药物用量。结果A组和B组进行以下指标比较：血压、心率差异无统计学意义(P>0.05)；术中静脉镇静药物用量研究组为(42.80±8.27)mL,对照组为(20.23±1.57)mL,差异有统计学意义(P<0.
3、05)；术后镇痛追加的次数研究组为(6.00±1.54)次，对照组为(12.80±3.87)次，差异有统计学意义(P<0.05)。结论神经刺激仪引导腰丛-腰椎旁神经阻滞用于老年患者股骨头置换术的麻醉效果可靠、安全，术后镇痛效果比单次蛛网膜下腔麻醉满意。［关键词］神经刺激仪；腰丛阻滞；老年患者；股骨头置换术[中图分类号]R614.4[文献标识码]A[文章编号]1673-7210(2014)08(b)-0026-04Clinicalobservationoffemoralheadreplacement
4、forelderlypatientsby1umbarplexus-paravertebralnerveblockZHAOZhiyangDepartmentofAnesthesia,BeijingAerospaceGeneralHospital,Beijing100076,China[Abstract]ObjectiveToexploreanesthosiaefficacy,safetyandpostoperativeanalgesicdoseforfemoralheadreplacementtoe
5、lderlypatientsofthelumbarPlexus-paravertebralnerveblockbyneuralStimulator・Methods62caseswithfemoralheadreplacement(29casesofgroupA,male20cases,female9cases；33casesofgroupB,male21cases,female12cases)inBeijingAerospaceGeneralHospitaifromDecember2008toDe
6、cember2012werecol1ected,groupAbythelumbarPlexus-paravertebranerveblockcombinedwithpropofol[4-6mg/(kg?h)]+fentanyl[0.0015-0.0020mg/(kg?h)]intravenoussedation,groupBspinalanesthesiacombinedwithpropofol[4~6mg/(kg?h)]+fentanyl[0.0015-0.0020mg/(kg?h)]intra
7、venoussedation；TropisetronhydrochlorideGlucoseInjection5mg+BuprenorphineHydrochlorideInjection(0.015一0・020mg/kg)wereusedbytwogroupsforpostoperativeanalgesia,Tuorenmedicaldevicesgroupproductionof100mLcontrolledpump・Anesthesiaefficacy,safetyandpostopera
8、tiveanalgesicdoseforfemoralheadreplacementtoelderlypatientswerecompared.ResultsTheresultsofgroupAandgroupBwerecompared：differencesofbloodpressureandheartratehadnostatisticsmeaning(P>0.05),dosageofsedationdrug：differencesbetweengroupAandgroupBw
