摘要
目的：探讨布比卡因等比重液腰-硬联合阻滞应用在股骨粗隆间骨折手术高龄患者中的安全性和可行性。方法：将2007年5月—2010年12月60例ASAI-III级70~98岁股骨粗隆间手术患者,随机分为硬膜外组（CEA组）、腰-硬联合麻醉组（SCEA组）,术中按6~8mL（kg.h）输注代血浆和复方乳酸钠液（1∶1）,根据血红蛋白和红细胞压积,以及心功能情况,输红细胞悬液。观察2组局麻醉药用量、感觉阻滞起效时间、阻滞完善时间。同时观察2组患者低血压、牵拉反应的发生率及静脉辅助药的应用率。结果：SCEA组感觉阻滞起效时间、阻滞完善时间明显快于CEA组（P〈0.05）。SCEA组硬膜外用药量明显少于CEA组（P〈0.05）。低血压的发生率2组无明显差异,CEA组牵拉反应的发生率高于SCEA组（P〈0.05）。SCEA组静脉辅助药的应用少于CEA组（P〈0.05）。2组术后恢复及不良反应差异无统计学意义。结论：布比卡因等比重液腰-硬联合麻醉应用在股骨粗隆间骨折手术高龄患者中是安全的。
Objective：To evaluate the safety and feasibility of spinal combined epidural anesthesia with Bupivacaine isobaric solution for older patients with intertrochanteric fractures operation.Methods： Sixty aged patients were randomized into epidural anesthesia group（EA group） and spinal combined epidural anesthesia group（SCEA group）.Observe local anesthetics dosage,feel block effect-acting period,stuck perfect time in both groups.And compare the incidence of hypotension,pull the incidence and reaction rates of auxiliary medicine vein in both groups.Results： Feel block effect-acting period and stuck perfect time significantly faster in SCEA group than that in EA group（P0.05）.CSEA group epidural exposure levels significantly was less than the EA group（P0.05）.The incidence rate of hypotension in two groups were no significant difference.In SCEA group,the use of auxiliary medicine was less than the CEA group（P0.05）.Postoperative recovery and adverse reaction in EA group and CSEA group were not different in statistically significance.Conclusions： Spinal combined epidural anesthesia with Bupivacaine isobaric solution for older patients with intertrochanteric fractures operation is safe.
出处
《中国临床医学》
2011年第4期544-545,共2页
Chinese Journal of Clinical Medicine
关键词
布比卡因
等比重液
腰-硬联合麻醉
股骨粗隆间骨折
Bupivacaine
Isobaric Solution
Intertrochanteric Fractures
Spinal combined epidural anesthesia
