【作者】 赵壮；

【导师】 杨希革；

【作者基本信息】 吉林大学 ， 临床医学， 2012， 硕士

【摘要】 目的：观察0.67%的罗哌卡因复合不同浓度葡萄糖用于中老年患者的腰麻效果比较。方法：选择年龄65-80岁ASA分级Ⅰ-Ⅱ级行择期单侧大隐静脉曲张高位结扎分段剥脱术的中老年患者80名，随机分为四组每组20例：5%葡萄糖组（A组）,10%葡萄糖组（B组）,25%葡萄糖组（C组）,50%葡萄糖组（D组）。所有患者患侧卧位，选择L3-4腰椎间隙进行穿刺。观察四组感觉运动神经阻滞情况,血液动力学变化麻醉效果以及不良反应。术中监测生命体征,术后随访并发症。结果：D组感觉运动阻滞起效时间明显比A.B.C组时间短(P <0.05),痛觉阻滞,运动阻滞持续时间明显比A.B.C组长(P <0.05)，但是C组腰麻阻滞平面较D组更加缓慢稳定。四组不良反应发生率都很低,差异无统计学意义(P>0.05),四组血液动力学变化差异无统计学意义(P>0.05)，四组中均无麻醉失败患者。结论：用0.67%罗哌卡因复合25%葡萄糖腰麻时，其起效时间，痛觉和运动阻滞时间效果虽不及50%葡萄糖组但是25%葡萄糖组腰麻阻滞平面较50%葡萄糖组更加缓慢稳定。四组血液动力学变化影响都较小，并发症的发生率四组相比亦无统计学差异，因此综合考虑0.67%罗哌卡因复合25%葡萄糖可以更加安全的用于中老年患者蛛网膜下腔阻滞。更多还原

【Abstract】 Objective：To observe the effect of0.67%ropivacaine combined differ-ent concentration of glucose on the aged patients underwent lumbar anesthesia.Methods：Eighty patients undergoing unilateral high ligation segmentationstripping of great saphenous varicose vein surgical procedures， aged from65～80years old，were randomly allocated to5%，10%，25%and50%glucose groups. All patients were affected lateral decubitus position. Lumbarspace of L3～4was selected to puncture. The sensorimotor nerve block，hemodynamics change and adverse reaction were observed. Vital signs of thepatients during operation were monitored. The patients were followed up afteroperation to record complications related anesthesia.Results： Onset of sensorimotor block in50%glucose group was shorterthan that of the other three groups (P＜0.05)， algesia and motor blockduration in50%glucose group was longer than that of the other three groups(P＜0.05). But lumbar anesthesia block plane of25%glucose group wasmore stable than that of50%glucose group. There were very low incidences ofadverse reaction of the four groups without significant difference (P＞0.05).Four groups had no significant difference in hemodynamics changes (P＞0.05) and no anesthesia failure.Conclusions：0.67%ropivacaine combined25%glucose could safelyused in the aged patients with subarachnoid block.更多还原