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脊髓麻醉的诱导体位:坐位与侧卧位。

Induction position for spinal anaesthesia: sitting versus lateral position.

作者信息

Shahzad Khurrum, Afshan Gauhar

机构信息

Department of Anaesthesia, Aga Khan University Hospital, Karachi, Pakistan.

出版信息

J Pak Med Assoc. 2013 Jan;63(1):11-5.

Abstract

OBJECTIVE

To compare the effect of induction position on block characteristics (sensory and motor nerves) and haemodynamic stability in elderly patients with isobaric bupivacaine. Patient comfort was also looked at.

METHODS

The randomized single blinded study was conducted at the Aga Khan University Hospital, Karachi, from September 2007 to August 2008. A total of 70 patients aged >60 years of both genders were included. Spinal anaesthesia was performed either in sitting or lateral position according to random allocation. Assessments of sensory, motor block and heart rate, systolic and diastolic blood pressure were recorded for 20 minutes. SPSS 16 was used for statistical analysis.

RESULTS

There was no significant difference for haemodynamic variables heart rate, systolic and diastolic blood pressure. The onset of anaesthesia was faster in the sitting group (4.5 minutes vs 5.4 minutes). The motor block characteristics were similar in both the groups. The majority of patients who reported 'very comfortable' for induction position belonged to the lateral group.

CONCLUSION

Both sitting and lateral positions have similar effects on sensory and motor blockade and haemodynamic stability. However, patients generally found lateral position very comfortable.

摘要

目的

比较不同诱导体位对等比重布比卡因用于老年患者时阻滞特性(感觉和运动神经)及血流动力学稳定性的影响。同时观察患者的舒适度。

方法

2007年9月至2008年8月在卡拉奇的阿迦汗大学医院进行了一项随机单盲研究。纳入了70名年龄大于60岁的男女患者。根据随机分组,分别在坐位或侧卧位下行脊髓麻醉。记录感觉、运动阻滞及心率、收缩压和舒张压20分钟。使用SPSS 16进行统计分析。

结果

血流动力学变量心率、收缩压和舒张压无显著差异。坐位组麻醉起效更快(4.5分钟对5.4分钟)。两组的运动阻滞特性相似。报告诱导体位“非常舒适”的患者大多数属于侧卧位组。

结论

坐位和侧卧位对等比重布比卡因用于老年患者时的感觉和运动阻滞以及血流动力学稳定性有相似影响。然而,患者普遍感觉侧卧位非常舒适。

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