Abstract:

【Abstract】 Objective To investigate the anesthesia effect of middle-dose ropivacaine and bupiva-caine for lower limb operation in aged patients. Methods Fifty of agedtranscervical fracture patients who underwent surgical treatment were randomized into ropivacaine groupand bupivacaine group (n=25 each). The patients were given combined spinal epidural anesthesia (CSEA) by injection of 0.5%ropivacaine 2.5 mL or 0.5%bupivacaine 2.5 mL through subarachnoid cavity..During the anesthesia,2% lidocaine was added when the anesthesia effect was insufficiency. During the operation, the status of respiration and circulation were monitored for the evaluation of anesthesia effect and adverse reaction. Results The differences of anesthesia effect, maximum blockage plane and adverse reaction were insignificant between the two groups.(P>0.05)..The decrease of blood pressure was obvious in bupivacaine group(P<0.05). Ropivacaine group was slow in starting sensation blockage and had short duration,.and had mild motion blockage.(P<0.05).compared with those in bupivacaine group). Conclusion Both ropivacaine and bupivacaine had anesthetic effect for lower limb operation in aged patients. Ropivacaine is more suitable for the aged patients for its less effect on circulatory system, mild motion blockage and rapid recovery of motion blockage.

Key words: Ropivacaine, Bupivacaine, Aged patients, Lower limb operation

摘要：

【摘要】 目的 探讨在老龄患者下肢手术的麻醉中等效剂量罗哌卡因和布比卡因麻醉效果以及对手术的影响。方法 选择拟行股骨颈骨折手术老龄患者50例,随机分为罗哌卡因组(R组)和布比卡因组(B组)。两组均采用腰硬联合麻醉(CSEA),分别给予0.5%罗哌卡因2.5 mL和0.5%布比卡因2.5 mL注入蛛网膜下腔。术中麻醉效应不足时硬膜外给予2%利多卡因。术中监测呼吸循环状况,评估麻醉效果,并观察不良反应。结果 两组麻醉效果,最高阻滞平面及不良反应的差异无统计学意义(P>0.05),B组的血压下降更加明显(P<0.05),R组下肢感觉阻滞起效更慢,持续时间更短(P<0.05),下肢运动阻滞程度显著低于B组(P<0.05)。结论 罗哌卡因和布比卡因在老龄患者下肢手术的腰硬联合麻醉都有效,罗哌卡因对循环系统影响更小,运动神经阻滞更轻且恢复迅速,更适合老龄患者下肢手术麻醉中的应用。

关键词: 罗哌卡因, 布比卡因, 老龄患者, 下肢手术