[1]张海亮,郝静静△,路喻清,等.轻比重腰麻与腰丛坐骨神经阻滞在高龄患者髋部手术中的应用*[J].陕西医学杂志,2019,(9):1134-1137.
　ZHANG Hailiang,HAO Jingjing,LU Yuqing,et al.Application of light specific gravity spinal anesthesia and lumbar〖JZ〗 plexussciatic nerve block in hip surgery in elderly patients[J].,2019,(9):1134-1137.
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轻比重腰麻与腰丛坐骨神经阻滞在高龄患者髋部手术中的应用*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年9期
页码:
1134-1137
栏目:
临床研究
出版日期:
2019-09-05

文章信息/Info

Title:
Application of light specific gravity spinal anesthesia and lumbar〖JZ〗 plexussciatic nerve block in hip surgery in elderly patients
文章编号:
DOI:〖HT5K〗10.3969/j.issn.10007377.2019.09.008
作者:
张海亮; 郝静静△; 路喻清; 白延斌
延安大学附属医院（延安 716000）
Author(s):
ZHANG Hailiang; HAO Jingjing; LU Yuqing; et al.
Yan’an University Affiliated Hospital（Yan’an 716000）
关键词:
小剂量轻比重腰麻; 腰丛坐骨神经阻滞; 高龄患者; 髋部手术; 布比卡因
Keywords:
Key words 〖WT5BZ〗〖HT5”SS〗Low dose light specific gravity spinal anesthesia; Lumbar plexussciatic nerve block; Elderly patients; Hip surgery; Bupivacaine
分类号:
R737.31
文献标志码:
A
摘要:
摘 要 〖HT5K〗目的:对比分析小剂量轻比重布比卡因腰麻与超声引导联合神经刺激仪腰丛坐骨神经阻滞麻醉在高龄患者髋部手术中的麻醉效果。方法：选取择期行单侧髋部手术的高龄患者90例（年龄≥80岁），将其随机分为A、B两组各45例。A组：选择L23或L34间隙穿刺，给予布比卡因5mg轻比重腰麻液；B组：超声引导联合神经刺激仪腰丛坐骨神经阻滞，分别给予0.4%罗哌卡因25~30ml和0.375%罗哌卡因20~25ml,对比两组麻醉效果、血流动力学变化。结果：A组中有1例因平面减退需静脉药物辅助，B组中有2例因阻滞效果不完善需静脉药物辅助；两组患者在各时间点的血流动力学均无统计学差异；B组阻滞起效时间、运动恢复时间、术中维持时间均长于A组(P＜0.01),结论：小剂量轻比重腰麻效果确切，起效时间快，但术中维持时间较短，超声引导腰丛坐骨神经阻滞有时会引起阻滞不全，需静脉药物辅助，但术中维持时间更长，两种麻醉方法各有利弊，但均为高龄患者髋部手术一种安全有效的麻醉方案。
Abstract:
Abstract 〖WT5BZ〗〖HT5”SS〗Objective：To compare and analyze the anesthetic effect of two kinds of anesthesia methods (low dose light specific gravity bupivacaine spinal anesthesia combined with ultrasonic guidance combined with nerve stimulator lumbar plexussciatic nerve block anesthesia) in the elderly patients with hip surgery. Methods：Ninety elderly patients (age ≥ 80 years) who underwent unilateral hip surgery were randomly divided into two groups：Group A：L23 or L34 space puncture. Lumbar anesthesia with bupivacaine 5mg light specific gravity solution；Group B was treated with 0.4% ropivacaine 25~30ml and 0.375% ropivacaine 20~25 ml，respectively. Results：In group A，intravenous drugs were needed in 3 cases due to hypoplania and in 5 cases in group B because of the imperfect effect of block，there was no significant difference in hemodynamics between the two groups at different time points. The onset time，motor recovery time and intraoperative maintenance time of block in group B were longer than those in group A (P＜0.05). Conclusion：The effect of low dose light specific gravity spinal anesthesia is accurate and the onset time is fast，but the duration of operation is shorter than that of group A (P＜0.05). Ultrasoundguided lumbar plexussciatic nerve block sometimes leads to incomplete block，which needs intravenous drug assistance，but the duration of operation is longer. Both methods have advantages and disadvantages，but they are both safe and effective anesthetic schemes for hip surgery in elderly patients.

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备注/Memo

备注/Memo:
*陕西省自然科学基础研究计划项目(2018JM7067)
更新日期/Last Update: 2019-09-24