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单次硬膜外麻醉在老年胸腰椎压缩骨折患者行经皮球囊扩张椎体成形术中的应用

发布时间:2018-01-20 15:15

  本文关键词: 硬膜外麻醉 老年 胸腰椎压缩骨折 经皮球囊椎体扩张术 单次给药 出处:《实用医学杂志》2015年22期  论文类型:期刊论文


【摘要】:目的:研究单次硬膜外麻醉在老年胸腰椎压缩骨折患者经皮球囊扩张椎体成形术(PKP)中的应用。方法:对2013年1月至2014年12月于硬膜外麻醉下行PKP的老年患者进行回顾性研究。检索患者一般情况、手术部位、硬膜外穿刺部位、穿刺操作时间、硬膜外用药、麻醉阻滞范围等。提取并分析麻醉前(T1)、穿刺后5 min(T2)、达到阻滞目标时(T3)、手术开始时(T4)、手术开始后30 min(T5)及手术结束时(T6)的血压和心率。结果 :共25例患者纳入研究,其中23例患者应用硬膜外麻醉,穿刺间隙与手术部位距离(1.8±1.2)个节段,应用不同局麻药的种类及容量分别为1%利多卡因+0.375%罗哌卡因(9.0±2.6)m L和1.5%利多卡因(8.9±3.0)m L。2例患者因硬膜外穿刺失败改为腰麻。所有患者均达到满足手术需要的阻滞范围并顺利完成手术。与T1相比,T2~T5时患者的平均压均显著降低(P0.05),以T3的平均压最低(降低13.8%)。结论 :对行PKP的老年患者应用单次硬膜外麻醉,麻醉平面可满足手术要求,麻醉期间血流动力学较平稳。
[Abstract]:Objective: to study the effect of single epidural anesthesia on percutaneous balloon dilatation vertebroplasty (PKP) in elderly patients with thoracolumbar compression fracture. Methods: a retrospective study was conducted on elderly patients with PKP under epidural anesthesia from January 2013 to December 2014. Surgical site, epidural puncture site, puncture operation time, epidural medication, anesthesia block, etc. Blood pressure and heart rate of T3, T4, T5 and T6 at the beginning of operation and at the end of operation. Results: a total of 25 patients were included in the study. 23 patients were treated with epidural anesthesia. The distance between the puncture space and the site of operation was 1.8 卤1.2 segments. The types and volumes of different local anesthetics were 1% lidocaine 0.375% ropivacaine 9.0 卤2.6 mL and 1.5% lidocaine 8.9 卤3.0 respectively. ML.2 patients were treated with spinal anesthesia due to the failure of epidural puncture. All the patients achieved the range of block to meet the need of operation and completed the operation successfully, compared with T1. The mean pressure of T _ 2 / T _ 5 group was significantly lower than that of T _ 3 group, and the mean pressure of T _ 3 was the lowest (the decrease of 13.8%). Conclusion: single epidural anesthesia was used in the elderly patients with PKP. The level of anesthesia can meet the requirement of operation, and hemodynamics is stable during anesthesia.
【作者单位】: 北京大学肿瘤医院暨北京市肿瘤防治研究所麻醉科恶性肿瘤发病机制及转化研究教育部重点实验室;卫生部北京医院麻醉科;
【分类号】:R687.3
【正文快照】: 骨质疏松性椎体压缩骨折是常见的老年性疾病,经皮球囊扩张椎体成形术(percutaneouskyphoplasty,PKP)作为治疗胸腰椎压缩骨折的微创技术近年来得到迅速发展[1-3]。老年患者全身性生理功能降低,合并症发生率高,麻醉风险较大,如何为这类患者提供舒适、有效的麻醉,保证围手术期安

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相关期刊论文 前10条

1 郑自富;项q,

本文编号:1448668


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