摘要
Abstract
Objective To investigate the effect of low dose bupivacaine for combined spinal epidural anesthesia (CSEA) on hemodynamics in elderly patients with total hip replacement .Methods Fifty ASA ⅡorⅢelderly patients of both sexes ,aged above 70 years undergoing total hip replacement were randomly allocated into two groups (n=25 each):the CSEA group(group C) and the epidural anesthesia group(group E) .After successful puncture ,0 .5% bupi‐vacaine isobaric solution 1 .5-2 mL was injected slowly to subarachnoid cavity in the group C ,then the epidural cath‐eter was placed .In the group E ,2% lidocaine 3mL was injected as a test dose ,according to the level of anesthesia for additional 2% lidocaine 5‐8mL adjusting the level of anesthesia under T8 .The onset time of anesthesia and the level of anesthesia ,blood pressure ,heart rate and pulse oxygen saturation were recorded .Results The onset time and level fixed time of anesthesia in the group C were shorter than those in the group E ,the differences were statistically sig‐nificant (P<0 .01) .The SBP at T3 -4 in the group E was decreased than that in the group C(P<0 .05) .Compared with the baseline ,SBP ,DBP and HR at T2 in the group C and SBP ,DBP at T2 -4 in the group E were decreased(P<0 .05 or P<0 .01) .Conclusion CSEA with low dose bupivacaine has many advantages of less medication ,rapid ac‐tion ,perfect analgesia ,good muscle relaxation and hemodynamic stability in the elderly patients with total hip replace‐ment ,w hich is a safe and reliable method of anesthesia and deserves to be clinincally used .关键词
腰硬联合麻醉/布比卡因/血流动力学/全髋置换术/高龄Key words
combined spinal epidural anesthesia/bupivacaine/hemodynamic/total hip replacement/advanced age
