芬太尼复合小剂量布比卡因腰麻在老年患者下肢手术中的应用-论文.pdf

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1、·1088·2013年11月第29卷第11期JClinAnesthesiol，Novembe!!：!：．临床研究·芬太尼复合小剂量布比卡因腰麻在老年患者下肢手术中的应用汪伟郁万友钱燕宁【摘要】目的观察老年患者下肢手术中采用芬太尼复合布比卡因腰麻的临床效果。方法择期行下肢手术的老年患者120例，随机均分为三组：A组蛛网膜下腔仅注入0．5布比卡因4mg，B组和C组分别复合芬太尼1Og和2Og。记录感觉和运动阻滞时间以及术后不良反应发生情况。结果A组最高阻滞平面明显低于B、c组(P

2、阻滞时间明显长于A、B组，且B组明显长于A组(P

3、yUzn·you，elANYan—ning．Department0fAnesthesiology，JiangningHospitalAfiliatedtoNanjingMedicalUniversity，Naniing211000，ChinaCorrespondingauthor：QJANYah—ning，Email：yanning_qian@163．corn[Abstract]ObjectiveToinvestigatetheclinicaleffectsofusing10gor2O／lgfen

4、tanylcombinedwith4mgbupivacaineinelderlypatientsundergoinglowerlimbsurgery．MethodsOnehundredandtwentycasesofelderlypatientsundergoinglowerlimboperation，ASAIorII，wererandomlydividedintothreegroupsaccordingtodrugoflumbaranesthesia：groupAreceivedasubarac

5、hnoidinjectionof4mg0．5bupivacaine，whereasgroupsBandCreceivedsubarachnoidinjectionsof4mg0．5bupivacaineplus10／*gor20gfentanyl，respectively．Thespinalanesthesiadrugsofallthreegroupsweredilutedto2mlisobaricsolutionusingnormalsaline．BP，HR，theincidenceofhypo

6、tension，ephedrineusage，sensoryandmotorblockonsettimeandtheoccurrenceofadversereactionsafteroperationswerealsorecordedinallthreegroups．Incasethe1evelofsensoryblockcouldnotmeettheoperationrequirements。patientsreceivedanextra5-10mlof1．5lidocaineepidurall

7、y．ResultsPatientsingroupsBandCwereallsatisfiedwithanesthesiawhilefivepatientsingroupArequiredsupplementaryepiduralanesthetics．ThehighestlevelofsensoryblockingroupAwaslowerthanthoseingroupsBandC．Therewasnosignificantdifferencebetweenthelattertwogroups．

8、OnepatientineachofgroupsAandBrequiredephedrineduetohypotension，whilenopatientsingroupChadthisrequirement．DurationofsensoryblockingroupCwassignificantlylongerthanthoseingroupsAandB(P