小剂量不同浓度罗哌卡因麻醉在老年膝髋关节置换中的效果

发布时间：2018-06-30 00:05

本文选题：麻醉 + 关节成形术　；参考：《中国组织工程研究》2017年15期

【摘要】：背景:老年膝髋关节置换中为了减轻围术期疼痛,给予罗哌卡因单侧腰-硬联合麻醉能取得预期的麻醉效果,但是选择何种浓度的小剂量轻比重效果成为研究的热点。目的:探讨小剂量轻比重不同浓度罗哌卡因单侧腰-硬联合麻醉在老年膝髋关节置换中的麻醉及镇痛效果。方法:纳入2014年8月至2015年12月收治的老年膝髋关节置换患者90例,采用随机数字方法分为0.15%、0.5%及0.25%罗哌卡因组,各30例,分别以0.15%、0.5%及0.25%罗哌卡因在L3-4或L2-3间隙进行穿刺麻醉。结果与结论:(1)0.25%罗哌卡因组平面消退时间及运动阻滞恢复时间低于0.5%罗哌卡因组(P0.05),高于0.15%罗哌卡因组(P0.05);0.25%罗哌卡因组运动阻滞起效时间长于0.5%罗哌卡因组(P0.05);短于0.15%罗哌卡因组(P0.05);0.15%罗哌卡因组平面消退时间及运动阻滞恢复时间短于0.5%罗哌卡因组(P0.05);0.15%罗哌卡因组运动阻滞起效时间长于0.5%罗哌卡因组(P0.05);(2)0.25%罗哌卡因组麻醉后1,5,10 h及术后24 h目测类比评分低于0.15%罗哌卡因组(P0.05),高于0.5%罗哌卡因组(P0.05);0.5%罗哌卡因组麻醉后1,5,10 h及术后24 h目测类比评分低于0.15%罗哌卡因组(P0.05);(3)3组麻醉后3,10,30 min及手术毕心率及平均血压水平均发生轻微波动,但是0.25%罗哌卡因组波动幅度最小;其次为0.15%罗哌卡因组,0.5%罗哌卡因组波动幅度最大;(4)0.25%罗哌卡因组麻醉后不良反应发生率,高于0.15%罗哌卡因组(P0.05),低于0.5%罗哌卡因组(P0.05);0.5%罗哌卡因组麻醉后不良反应发生率,高于0.15%罗哌卡因组(P0.05);(5)提示剂量为0.25%罗哌卡因3 mL能取得预期的麻醉效果。
[Abstract]:Background: in order to relieve perioperative pain in hip arthroplasty in elderly patients, ropivacaine combined with unilateral spinal-epidural anesthesia can achieve the desired anesthetic effect, but the choice of low dose light specific gravity effect has become a hot research topic. Objective: to investigate the analgesic effect of low dose and light specific gravity ropivacaine combined with unilateral spinal-epidural anesthesia in elderly knee hip arthroplasty. Methods: from August 2014 to December 2015, 90 elderly patients with hip replacement were randomly divided into 0.15% ropivacaine group and 0.25% ropivacaine group, 30 patients were treated with 0.15% ropivacaine or 0.25% ropivacaine respectively. Results and conclusion: (1) the time of regression and recovery of motor block in 0.25% ropivacaine group was lower than that in 0.5% ropivacaine group (P0.05), and the onset time of motor block in 0.25% ropivacaine group was shorter than that in 0.5% ropivacaine group (P0.05). The onset time of motor block in pivacaine group (P0.05) was shorter than that in 0.5% ropivacaine group (P0.05). (P0.05) the onset time of motor block in 0.15% ropivacaine group was longer than that in 0.5% ropivacaine group (P0.05); (2) 0.25% ropivacaine 0.25% ropivacaine 1: 510 h after anesthesia and 24 hours after operation. H visual analogue score was lower than 0.15% ropivacaine group (P0.05), higher than 0.5% ropivacaine group (P0.05) and 0.5% ropivacaine group (P0.05). Visual analogue score of 0.5% ropivacaine group was lower than 0.15% ropivacaine group (P0.05); (3). Blood pressure levels all fluctuated slightly, But the fluctuation range of 0.25% ropivacaine group was the least, followed by 0.15% ropivacaine group and 0.5% ropivacaine group. (4) the incidence of adverse reactions after anesthesia in 0.25% ropivacaine group, 0.15% ropivacaine group, 0.5% ropivacaine group and 0.25% ropivacaine group. The incidence of adverse reactions was higher than 0.15% ropivacaine group (P0.05) and lower than 0.5% ropivacaine group (P0.05), and higher than 0.15% ropivacaine group (P0.05); (5) indicated that 0.25% ropivacaine 3 mL could achieve the expected anesthetic effect.
【作者单位】：河南中医药大学第二附属医院麻醉科;
【基金】：河南省卫生厅科技攻关项目(A20140307)~~
【分类号】：R614

【相似文献】