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时间:2020-04-21
《不同剂量舒芬太尼复合罗哌卡因腰麻在高龄患者手术中的应用-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、HainanMedJ'Apr.2014,Vo1.25,No.7海南医学2014年4月第25卷第7期doi:10.3969/j.issn.1003—6350.2014.07.0379不同剂量舒芬太尼复合罗哌卡因腰麻在高龄患者手术中的应用张彩玲,陈伟元(梅州市人民医院麻醉三科,广东梅州514000)【摘要】目的探讨不同剂量舒芬太尼复合罗哌卡因腰麻用于高龄患者手术的有效性和安全性。方法选择150例85岁及以上择期行会阴部及下肢手术患者,随机分为三组:A组50例给予7.5mgO.5%罗哌卡因+1.5窟舒芬太尼;B组50例给予7.5mgO.5%罗哌卡因+2.
2、5g舒芬太尼;C组5O例给予7.5mg0.5%罗哌卡因+3.5lag舒芬太尼。比较三组患者的感觉运动阻滞情况、血流动力学变化以及腰麻后的副反应。结果在血流动力学方面,三组麻醉后的MAP值、HR值比较差异均无统计学意义(,0.05)。在感觉和运动阻滞疗效方面,B、C组明显优于A组(P0.05)。在腰麻后副反应中,除C组的尿潴留发生率显著高于A、B组(P0.05)。结论小剂量的舒芬太尼复合罗哌卡因腰麻可安全有效应用于高龄患者手术,其中以7.5mg0.5%
3、罗哌卡因复合2.5lag舒芬太尼麻醉效果最佳,不良反应少。【关键词】舒芬太尼;罗哌卡因;腰麻;高龄患者【中图分类号】R614.3【文献标识码】A【文章编号】1O03—6350(2O14)07—0977—O3Spinalanesthesia、vithropivacainecombinedthsufentanilintheelderpatients.ZHANGCai-ling,CHENWei—yuan.TheThirdDepartmentofAnesthesiology,People"sHospitalofMe&ho~Meizhou514000,Gua
4、ngdong,CHINA【Abstract】ObjectiveTodiscusstheclinicalefectivityandsafetyofspinalanesthesiawithropivacainecombinedwithsufentanilintheelderly.MethodsSpinalanesthesiawasperformedin150patients,agedmorethan85yearsoldandundergoingselectivelowerlimbsurgery,whowereequallyrandomizedintot
5、hreegroups.Agroupre-ceivedO.5%ropivacaine7.5mgplussufentanil1.5lag.Bgroupreceived0.5%ropivacaine7.5mgplussufentanil2.5lag.CgroupreceivedO.5%ropivacaine7.5mgplussufentanil3.5lag.Comparethesituationofsensorimotorblock,hemodynamicchanges,andsideefectsinthreegroupsafterspinalanest
6、hesia.ResultsTheMAP,HRofthreegroupafterspinalanesthesiahadnosignificantdiferenceamongthem.Intermsofsensorimotorblockefect,BgroupandCgroupwerebetterthangroupA(P<0.05),buttherewasnostatisticalsignificancebetweenBgroupandCgroup.Atthecomparisonsofsideefectsafterspinalanesthesia,on
7、lytheincidenceofurinaryretentioningroupCwassignificantlyhigherthanthatingroupAandgroupB(P<0.05),theincidenceofthesideefectswerenotincreas—ingsignificantly.ConclusionSmalldoseofropivacainecombinedwitIlsufentanilcanbeefectivelyandsafelyap-pliedtoelderlypatientswithoperation.Thes
8、chemeofO.5%ropivacaine7.5mgplussufentanil2.5lagamongthemhasth
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