摘要
目的探讨轻比重布比卡因单侧腰部麻醉(简称腰麻)在老年单侧腹股沟疝手术中的临床研究。方法选择40例择期行单侧腹股沟疝手术的老年患者,分为2组,对照组(Ⅰ组)为常规双侧腰麻,试验组(Ⅱ组)为单侧腰麻,记录2组给药前后各时段血压、心率、脉搏氧饱和度、起效时间、麻醉平面维持时间,术中低血压、心动过缓,术后不良反应情况,分别评定麻醉效果。结果2组患者麻醉效果满意,均顺利完成手术,但Ⅰ组低血压、心动过缓发生例数明显多于Ⅱ组(P<0.05);2组患者麻醉前、牵拉疝囊时血压心率变化(牵拉反应)差异无统计学意义(P>0.05);麻醉平面固定后Ⅰ组平均动脉血压、心率变化与Ⅱ组比较,差异有统计学意义(P<0.05),Ⅰ组术后恶心呕吐和尿潴留的发生率要高于Ⅱ组(P<0.05)。结论轻比重布比卡因单侧腰麻应用于老年腹股沟疝手术,麻醉药用量小、效果好、并发症少,对生命体征影响小。
Objective To explore the safety and feasibility in elderly inguinal hernia surgery,observe the effect and adverse reaction of the unilateral lumbar hemp using hypobaric bupivacaine in the elderly inguinal herma surgery. Methods Forty elderly patients with ASA physical statusⅡ or Ⅲ undergoing inguinal hernia surgery were randomly divided into two groups with 20 in each group;the control group （group I ） was treated for bilateral lumbar hemp,and the experimental group （group Ⅱ ） was treated for unilateral lumbar hemp. The BP, HR, pulse 02 saturation, anesthesia effect time, anesthesia plane maintenance time, the inci- dence rate of intraoperative hypotension,bradycardia and pull reaction, the incidence of postoperative complications were recorded at each period before and after drug delivery respectively, the anesthesia effect was evaluated. Results The analgesic effect of two groups were satisfied, but there were more hypotension and bradycardia in group I after anesthesia （P〈0.05） ;there was no signif- icant difference about intraoperative pull reaction rate between the two groups （P〉0.05）;however,after the anesthesia plane was fixed,the MAP and H R of group I fluctuated significantly（P〈0.05）;there were more nausea, vomiting and urinary retention in group I at postoperative （P〈0.05）. Conclusion The unilateral lumbar hemp using hypobaric bupivacaine in the elderly inguinal hernia surgery is a safe and satisfactory anesthesia method with a small dosage of anesthetic, small impact on the vital signs, satis- fied anesthesia effect and less anesthesia complications.
出处
《重庆医学》
CAS
北大核心
2015年第20期2787-2789,共3页
Chongqing medicine
基金
重庆市永川区科委面上项目(YCSTC2013NC8016)
关键词
老年
疝
腹股沟
单侧腰麻
elderly
hernia, inguinal
unilateral lumbar hemp
