川北医学院学报2024，Vol.39Issue(1)：92-95,4.DOI:10.3969/j.issn.1005-3697.2024.01.022
不同剂量罗哌卡因在老年关节置换手术中行腰硬联合麻醉的效果分析及对术后认知功能的影响
Application of different doses of ropivacaine in CSEA of elderly patients undergoing joint replacement and the impact on postoperative cognitive function
摘要
Abstract
Objective:To analyze the application of different doses of ropivacaine in combined spinal and epidural anesthesia(CSEA)of elderly patients undergoing hip replacement.Methods:109 elderly patients who underwent elective hip replacement were divided into group A(n =36),group B(n =36)and group C(n =37)according to the medication for anesthesia.Puncture in sub-arachnoid space was performed after puncture in the L3-4 gap.Group A,group B and group C were given subarachnoid injection of 10 mg,12 mg and 15 mg of ropivacaine(0.5%),respectively.Ropivacaine(1%)was injected into the epidural catheter to maintain an-esthesia.The anesthetic effects,pain degree(VAS)score,hemodynamics[arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2)],cognitive function(MMSE),and adverse reactions were compared between the groups.Results:The onset time of sensory and motor block in group B and group C was shorter than that in group A,and the recovery time was longer than that in group A(P<0.05).The recovery time of sensory and motor block in group B was shorter than that in group C(P<0.05).The VAS scores of group B and group C at 4 and 8 h after surgery were lower than those of group A(P<0.05).At T1,T2 and T3,HR and MAP of group C,group B,and group A increased in sequence(P<0.05).The MMSE scores of group A and group B at the end of surgery and 24 h after operation were higher than those of group C(P<0.05).The incidence rates of adverse reactions in group A and group B were lower than that in group C(P<0.05).Conclusion:12 mg of ropivacaine can achieve more ideal effect in CSEA for elderly pa-tients undergoing hip replacement,with less influence on hemodynamics and cognitive function,and with high safety.关键词
髋关节置换术/罗哌卡因/腰硬联合麻醉/麻醉效果/血流动力学/认知功能Key words
Hip replacement/Ropivacaine/Combined spinal-epidural anesthesia/Anesthetic effect/Hemodynamics/Cognitive function分类
医药卫生引用本文复制引用
宋瑞月,吴迪..不同剂量罗哌卡因在老年关节置换手术中行腰硬联合麻醉的效果分析及对术后认知功能的影响[J].川北医学院学报,2024,39(1):92-95,4.基金项目
北京市2021 通州区科委课题(KJ2021CX008-15) （KJ2021CX008-15）
