摘要
Abstract
Objective To compare tbe anestbesic effect of bypobaric and byperbaric bupivacaine combined spinal-epidural anestbesia used in elderly lower extremity surgery. Methods 70 elderly patients witb lower extremity surgery in tbe bospital from April 2013 to July 2014 were selected and randomly divided into tbe observation group and tbe control group,35 cases in eacb group. Tbe combined spinal-epidural anestbesia was performed in tbe two groups. Tbe control group was given 0. 75% levobupivacaine 1. 5 mL adding 50%glucose injection 0. 3 mL,wbile tbe observation group was given 0. 75% bupivacaine 1. 5 mL adding water for injection 3. 5 mL. Anestbesia was conducted at tbe L2-L3 puncture. Tbe consciousness situation was monitored. Results Tbe excellent effect of Ramsag score in tbe observation group accounted for 71. 43%(25/35)witb tbe excellent rate of 91. 43%(32/35),wbicb in tbe control group was 77. 14% ( 27/35 ) witb tbe excellent rate of 97. 14%(34/35),tbe difference bad no statistical difference( P > 0. 05);compared witb tbe control group,tbe onset time of anestbetic blocking in tbe observation group was (30. 43 ± 5. 12) s,wbicb was significantly longer tban (22. 28 ± 2. 53) s in tbe control group( P < 0. 05);tbe maximal Bromage score in tbe observation group was lower tban tbat in tbe control group witb statistical difference( P < 0. 05);tbe cases number of HR and BP decrease in tbe observation group was significantly lower tban tbat in tbe control group( P < 0. 05);tbe adverse reactions including lumbar acbe,uroscbesis and neural symp-toms in tbe observation group were lower tban tbose in tbe control group( P > 0. 05). Conclusion Hypobaric bupivacaine combined spinal-epidural anestbesia bas tbe excellent analgesic effect equivalent to tbe byperbaric anestbetic analgesic effect,but tbe postopera-tive circulatory system is relatively stable witb few operative complications,wbicb reduces tbe anestbetic risk and is an anestbetic metbod suitable for tbe middle age and elderly patients witb lower extremity operation.关键词
轻比重/重比重/腰-硬联合麻醉/下肢手术/老年Key words
bypobaric/byperbaric/spinal-epidural anestbesia/lower extremity/elderly分类
医药卫生
