等效剂量罗哌卡因和布比卡因蛛网膜下腔阻滞在老年前列腺增生患者经尿道前列腺电切术中的应用观察

发布时间：2018-07-04 15:55

本文选题：老年人 + 蛛网膜下腔阻滞　；参考：《山东医药》2015年19期

【摘要】：目的比较等效剂量罗哌卡因和布比卡因蛛网膜下腔阻滞在老年前列腺增生患者经尿道前列腺电切术中的应用效果。方法 80例前列腺增生患者,均接受经尿道前列腺电切术治疗,随机分为B组与R组,B组给予0.3%布比卡因2.4 m L行蛛网膜下腔阻滞,R组给予0.5%罗哌卡因2.4 m L行蛛网膜下腔阻滞。观察两组患者的麻醉效果、呼吸抑制以及并发症发生情况。结果两组最高麻醉平面比较无统计学差异;与B组相比,R组T12阻滞维持时间、镇痛维持时间、运动阻滞维持时间短,感觉阻滞起效时间、运动阻滞起效时间长(P均0.01)。与麻醉前相比,B组麻醉后基础潮气量、每分钟静息通气量、呼气峰流量和第1秒用力呼气量均降低(P均0.05)。与B组相比,R组麻醉后基础潮气量、每分钟静息通气量、呼气峰流量、第1秒用力呼气量高(P均0.05)。两组均未出现严重心律失常和术后腰痛。结论与布比卡因蛛网膜下腔阻滞相比,老年前列腺增生患者在经尿道前列腺电切术中应用等效剂量的罗哌卡因感觉和运动恢复更快,对患者呼吸功能的影响更小,具有更高的安全性。
[Abstract]:Objective to compare the effect of equivalent dose ropivacaine and bupivacaine subarachnoid block in transurethral resection of prostate in elderly patients with prostatic hyperplasia. Methods 80 patients with benign prostatic hyperplasia were treated by transurethral resection of prostate. Group B and group R were randomly divided into two groups: group B and group B were given 0.3% bupivacaine 2.4 mL for subarachnoid block. Group R was given 0.5% ropivacaine 2.4 mL for subarachnoid block. The anesthetic effect, respiratory inhibition and complications were observed in both groups. Results there was no significant difference in the highest anesthesia level between the two groups, and the maintenance time of T12 block, analgesia, motor block, sensory block and motor block were shorter than those in group B (P 0.01). Compared with those before anesthesia, the basic tidal volume, resting ventilation volume per minute, peak expiratory flow and forced expiratory volume at the 1st second in group B were significantly lower than those before anesthesia (all P 0.05). Compared with group B, the basic tidal volume, resting ventilation volume, peak expiratory flow and forced expiratory volume in group R were higher than those in group B (P 0.05). There was no severe arrhythmia and postoperative low back pain in both groups. Conclusion compared with Bupivacaine subarachnoid block, the sensory and motor recovery of the elderly patients with prostatic hyperplasia treated with equivalent dose of ropivacaine during transurethral resection of the prostate is faster, and the effect of ropivacaine on respiratory function is less than that of Bupivacaine in subarachnoid block. It has higher security.
【作者单位】：新疆喀什地区第二人民医院;同济大学附属上海市肺科医院;
【分类号】：R614.4

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