老年患者硬膜外麻醉不同给药方式的临床研究

发布时间：2018-04-23 02:27

本文选题：硬膜外麻醉 + 高龄　；参考：《航空航天医学杂志》2016年09期

【摘要】：目的比较硬膜外不同给药方式在老年患者手术中的临床效果分析。方法 96例择期行手术的老年患者,按照不同的给药方式将患者均为两组(n=48)。持续给药组患者实施连续硬膜外穿刺成功后注入2%利多卡因试验量3 m L,调节麻醉平面达T10且固定后根据患者情况硬膜外连续输注2%利多卡因3~5 m L/h,至手术结束。分次给药组患者同样行硬膜外麻醉,调节麻醉平面达T10且固定后硬膜外分次注入2%利多卡因3~5 m L/h,每半小时注射1次。观察两组麻醉阻滞情况及不同时间点血流动力学变化。结果两组患者感觉阻滞起效时间基本相同,均能阻滞到最高平面T10,但持续给药组阻滞完善时间和用药总量均少于分次给药组,差异有显著性意义(P0.05)。给药后两组血压均有明显下降,分次给药组术中追加药物后血压较持续给药组下降明显(P0.05),波动较大,不如持续给药组稳定。结论硬膜外麻醉持续给药比传统的间断分次给药对老年患者血流动力学的影响小,有利于维持循环稳定,提高围术期安全性。
[Abstract]:Objective to compare the clinical effects of different epidural administration methods in elderly patients. Methods 96 elderly patients undergoing elective operation were divided into two groups according to different administration methods. After continuous epidural puncture, 2% lidocaine was injected into 3 mL, and the anesthesia level was adjusted to T10. After continuous epidural infusion of 2% lidocaine 3 mL / h, 2% lidocaine was injected continuously to the end of the operation according to the patient's condition. The patients in the subgroup were also given epidural anesthesia. The anesthesia level was adjusted to T10 and the epidural injection of 2% lidocaine was injected 5 mL / h, once every half hour. The anesthetic block and hemodynamic changes at different time points were observed. Results the onset time of sensory block in the two groups was basically the same, both of them could block to the highest level T10, but the perfect time and the total amount of the block in the continuous administration group were less than those in the graded administration group, and the difference was significant (P 0.05). The blood pressure of the two groups decreased obviously after administration. The blood pressure of the two groups decreased obviously compared with the continuous administration group after adding drugs during the operation, and the fluctuation was larger than that of the continuous administration group, which was less stable than that of the continuous administration group. Conclusion the effect of continuous epidural anesthesia on hemodynamics of elderly patients is less than that of traditional intermittent administration, which is helpful to maintain stable circulation and improve perioperative safety.
【作者单位】：辽阳市第二人民医院麻醉科;辽河油田第二职工医院;大连市沙河口区妇幼保健院;
【分类号】：R614.42

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