摘要
目的:评估脉搏灌注指数(pulse oximeter perfusion index,PI)在判断老年男性患者低位硬膜外麻醉阻滞效果中的应用。方法:66例美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅰ~Ⅲ级、年龄≥60岁的男性患者经硬膜外导管给予2%利多卡因后观察30 min,记录针刺皮肤测痛时双侧脚趾PI、针刺皮肤测痛时痛觉的变化以及提睾反射消失的时间。PI的变化率≥100%、痛觉及提睾反射消失考虑硬膜外麻醉阻滞有效。不同时刻PI的比较使用单因素重复测量方差分析,PI与提睾反射及针刺皮肤测痛预测硬膜外麻醉的成功率在各时刻点的比较使用配对四格表资料的卡方检验。结果:硬膜外腔给药后2 min PI逐渐增加,4 min痛觉开始减退,20 min提睾反射开始消失。在硬膜外腔给药后10、20及30 min各时刻点所有患者的PI均增加100%(P=0.000),针刺皮肤测痛的结果是0/66、45/66(χ2=24.973,P=0.000)、66/66,提睾反射消失的结果是0/66、51/66(χ2=16.923,P=0.000)、66/66。结论:PI是评估老年男性患者低位硬膜外麻醉阻滞效果的早期、客观指标。
Objective :To investigate the value of pulse oximeter perfusion index(PI)in assessing the blocking effect of lower epidural anesthesia in elderly male patients.Methods :A total of 66 male patients aged ≥60years with American Society of Anesthesiologists grade Ⅰ-Ⅲ were given 2%lidoeaine via the epidural eatheter and then observed for 30minutes.The changes in PI and pain sensation of the toes of both feet during needle prick and the time to the disappearance of cremasteric reflex were recorded.A PI change rate of ≥100%and the disappearance of pain sensation and eremasterie reflex were considered effective epidural blockage.A oneway analysis of variance with repeated measures was used for comparison of PI at different time points,and the chi-square test of paired fourfold data was used for comparison of the success rates of PI,cremasteric reflex,and pain measurement with needle prick in indicating epidural anesthesia at different time points.Results:PI gradually increased at 2minutes after epidural administration and the pain with needle prick started to decrease at 4minutes,and eremasteric reflex started to disappear at 20minutes.At 10,20,and 30minutes after epidural administration,all the patients aehieved a 100%increase in PI(P=0.000);0,45,and 66patients,respeetively,had no sense of pain during needle prick,and there was.a significant increase in the number of patients from 10to 20minutes(X2=24.973,P=0.000);0,51,and 66patients,respectively,had the disappearance of cremasteric reflex,and there was a significant increase in the number of patients from 10 to 20 minutes(x^2=16.923,P=0.000).Conclusion:PI is an early and objective index of the blocking effect of lower epidural anesthesia in elderly male patients.
作者
熊秋菊
程波
何开华
闵苏
魏珂
Xiong Qiuju;Cheng Bo;He Kaihua;Min Su;Wei Ke(Anesthesiology Department,The First Affiliated Hospital of Chongqing Medical University)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2018年第11期1504-1507,共4页
Journal of Chongqing Medical University
基金
国家临床重点专科建设项目经费资助项目(编号:2011-170)
重庆市医学重点学科建设经费资助项目(编号:2007-2)
关键词
脉搏灌注指数
低位硬膜外麻醉
阻滞效果评价
老年男性患者
pulse oximeter perfusion index
lower epidural anesthesia
blocking effect assessment
elderly male patient
