摘要
目的探讨小剂量舒芬太尼-罗哌卡因腰硬联合麻醉在老年下肢骨科手术中的临床效果。方法将行下肢骨科手术的患者45例随机分为3组,每组15例。Ⅰ组:罗哌卡因10 mg;Ⅱ组罗哌卡因7.5 mg加舒芬太尼2.5μg;Ⅲ组:罗哌卡因7.5 mg加舒芬太尼5μg。均用生理盐水配成2.0ml溶液,分别注入蛛网膜下腔。观察3组患者的血压、心率变化,有效镇痛时间及恶心、呕吐、皮肤瘙痒、呼吸抑制等不良反应。结果所有患者麻醉镇痛完善。Ⅱ、Ⅲ组患者6、9、12、15、20 min的SBP、DBP均高于Ⅰ组(P<0.01),Ⅱ、Ⅲ组之间无差异;其他时间、血压比较则无统计学意义。Ⅱ、Ⅲ组患者运动神经阻滞持续时间及有效镇痛时间均高于Ⅰ组(P<0.01)。Ⅰ组不良反应多于Ⅱ、Ⅲ组。结论小剂量舒芬太尼-罗哌卡因腰硬联合麻醉对血流动力学影响小,有效镇痛时间延长,适合于老年下肢手术,但应注意与舒芬太尼剂量相关的皮肤瘙痒。
Objective To explore the clinical therapeutic effects of cesarean section with epidural anaesthesia （CSEA） of a low dose of sufentanil citrate and ropivacaine in senile lower limb surgery, Methods 45 case of lower limb surgery at ASA Ⅰ - Ⅱ stage, ranging from 65 to 80, were randomly divided into three groups, 15 cases in each group. 10 mg of ropivacaine was used in Group One. 7.5mg ropicacaine and 2.5μg of sufentanil citrate were used in Group Two. 7.5mg of ropivacaine and 5μg of sufentanil citrate were used in Group Three. Results All these drugs were mixed with NS to get 2.0ml of .solution respectively before being injected into subarachnoid cavity. The changes in blood pressure and heart beats,the time of analgesia and the side effects of nausea,vomiting, cutaneous pruritus and respiratory inhibition and shivere were found higher in Group One than in G-roups Two and Three. There existed significant rheological differences when Group One was compared with G-roups Two and three（ P 〈 0.01 ）. Conclusion （7SEA of a low dose of ropivacaine and sufentanil citrate has a slight rheological effect and produced a long period of analgesia, therefore, it can be well applied to .senile lower limb surgery, but the side effects, such as cutancous pruritus caused by sufentanil and the dosage of it, should be taken into account in the treatment.
出处
《山东医学高等专科学校学报》
2008年第3期187-190,共4页
Journal of Shandong Medical College
关键词
舒芬太尼
罗哌卡因
腰硬联合麻醉
老年下肢骨科手术
Key words： Sufentanil citrate
Ropivacaine
Cesarean,section with epidural anaesthesia
Senile lower limb suegery.
