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低位布比卡因脊麻后老年患者体位改变的效果:感觉阻滞特点和血液动力学变化。

Effect of position changes after spinal anesthesia with low-dose bupivacaine in elderly patients: sensory block characteristics and hemodynamic changes.

机构信息

Department of Anesthesiology and Pain Medicine, Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.

出版信息

Korean J Anesthesiol. 2013 Mar;64(3):234-9. doi: 10.4097/kjae.2013.64.3.234. Epub 2013 Mar 19.

Abstract

BACKGROUND

The purpose of this study is to compare the anesthetic characteristics in elderly patients who remain in sitting position for 2 min compared with patients that are placed in supine position after induction of spinal anesthesia.

METHODS

Fifty-seven patients scheduled for transurethral surgery were randomized to assume supine position immediately after 6.5 mg hyperbaric bupivacaine were injected (L group) or to remain in the sitting position for 2 minutes before they also assumed the supine position (S group). Analgesic levels were assessed bilaterally, using pin-prick. Motor block was scored using a 12-point scale. The mean arterial pressure and heart rate were also recorded.

RESULTS

Sensory block levels were significantly lower at all time points for the L group. However, there were no significant differences in the degree of the motor block and hemodynamic changes between the two groups. However, in the L group, ephedrine or atropine were administered to three patients.

CONCLUSIONS

We concluded that performing a spinal anesthesia in sitting position was technically easier and induced less hypotension.

摘要

背景

本研究旨在比较 6.5mg 重比重布比卡因椎管内麻醉后,立即让患者取仰卧位与让患者取坐姿 2 分钟后再取仰卧位这两种情况下老年患者的麻醉特点。

方法

57 例行经尿道手术的患者被随机分为两组,一组在注射完 6.5mg 重比重布比卡因后立即取仰卧位(L 组),另一组取坐姿 2 分钟后再取仰卧位(S 组)。使用针刺法双侧评估镇痛水平。采用 12 分制评分法评估运动阻滞程度。还记录了平均动脉压和心率。

结果

L 组在所有时间点的感觉阻滞水平均显著较低。然而,两组之间的运动阻滞程度和血液动力学变化没有显著差异。然而,在 L 组中,有 3 名患者给予了麻黄碱或阿托品。

结论

我们得出结论,坐姿下进行椎管内麻醉在技术上更容易操作,且低血压的发生率更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ae/3611073/355627e6b025/kjae-64-234-g001.jpg

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