Sanatkar Mehdi, Sadeghi Mostafa, Esmaeili Nafiseh, Sadrossadat Hossein, Shoroughi Mehrdad, Ghazizadeh Shahrokh, Khoshraftar Ebrahim, Pour Anvari Hassan, Alipour Nasim
Department of Anesthesiology, Razi Hospital AND Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2013 Aug 7;51(7):438-43.
The aim of this study was to assess the effect of spinal block with low dose of bupivacaine and sufentanil on patients with low cardiac output who underwent lower limb surgery. Fifteen patients who had ejection fraction less than 40% (group 1) were compared with 65 cases with ejection fraction more than 40% (group 2) in our study. Our subjects underwent spinal block with 7.5 mg hyperbaric bupivacaine 0.5% and 5 µg sufentanil. We recorded early events such as hypotension, bradycardia, vasopressor need and ST segment change in our cases. The average mean arterial pressure decreased 13% (110 mmHg to 95.7 mmHg) in group 1 and 20% (160 mmHg to 128 mmHg) in group 2 (P<0.001). Hypotension due to spinal anesthesia was observed in none of our subjects in both groups and none of our cases need to vasopressor support. All patients remained alert, and no ST segment changes were observed in two groups. In our study none of subjects complained of pain intraoperatively. The subjects were without complaints during the spinal anesthetic in both groups. Spinal block with low dose local anesthetic and sufentanil was a safe and effective method for lower limb surgery in patients with low ejection fraction.
本研究旨在评估低剂量布比卡因和舒芬太尼脊髓阻滞对低心输出量且接受下肢手术患者的影响。在我们的研究中，将15例射血分数低于40%的患者（第1组）与65例射血分数高于40%的患者（第2组）进行了比较。我们的受试者接受了0.5%重比重布比卡因7.5 mg和舒芬太尼5 μg的脊髓阻滞。我们记录了病例中的早期事件，如低血压、心动过缓、血管升压药需求和ST段变化。第1组平均动脉压下降13%（从110 mmHg降至95.7 mmHg），第2组下降20%（从160 mmHg降至128 mmHg）（P<0.001）。两组受试者均未观察到因脊髓麻醉导致的低血压，且无一例需要血管升压药支持。所有患者均保持清醒，两组均未观察到ST段变化。在我们的研究中，没有受试者术中主诉疼痛。两组受试者在脊髓麻醉期间均无不适主诉。低剂量局部麻醉药和舒芬太尼的脊髓阻滞对于射血分数低的患者进行下肢手术是一种安全有效的方法。
