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Anesthesia, Obstetrical , Anesthesia, Spinal , Cesarean Section , Female , Humans , Methoxamine , Pregnancy , Pregnant WomenABSTRACT
OBJECTIVE:To explore the effect of subarachnoid block anesthesia in endoulogy minimally invasive surgery of el-derly patients. METHODS:198 elderly patients underwent endoulogy minimally invasive surgery were randomly divided into obser-vation group (100 cases) and control group (98 cases). Observation group received subarachnoid block anesthesia,and control group received epidural anesthesia. The anesthesia onset time,anesthesia dose,surgery time,complete block time,satisfaction de-gree of anesthesia effect,the occurrence of ADR were compared between 2 groups. RESULTS:Anesthesia onset time and complete block time of observation group were (1.5 ± 0.6) min and (7.9 ± 3.9)min,which were significantly shorter than those of control group (4.5 ± 1.2) and (17.5 ± 4.3) min,with statistical significance (P0.05). CONCLUSIONS:Subarachnoid block anesthesia consumes small dose,acts rapidly and shows significant anesthesia effect,it is used for endoulogy minimally invasive surgery of elderly patients.
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OBJECTIVE: To observe the potency ratio of hyperbaric to isobaric solutions of ropivacaine in subarachnoid block for knee arthroscopy. METHODS: Fifty patients receiving knee arthroscopy under combined spinal-epidural anesthesia were randomly divided into isobaric ropivacaine group and hyperbaric ropivacaine group (0.5% ropivacaine, prepared with equal volume of 10% glucose and 1% isobaric ropivacaine). Successful criteria of spinal anesthesia were (1) a bilateral loss of pinprick sensation at or above the level of T12; (2) adequate motor block during knee arthroscopy (modified Bromage's score ≥2); and (3) no requirement of additional epidural administration at least within 60 min after intrathecal injection. Drug consumption was determined with up-and-down method, and then ED50 was calculated. RESULTS: The ED50 of isobaric ropivacaine was 9.71 mg (95% CI 8.11-11.32), and the ED50 of hyperbaric ropivacaine was 6.55 mg (95% CI 6.07-7.04), and the relative potency ratio was 0.67 (95% CI 0.56-0.80) for hyperbaric/isobaric ropivacaine. CONCLUSIONS: The ED50 of hyperbaric ropivacaine is less than that of isobaric ropivacaine in subarachnoid block anesthesia for knee arthroscopy.
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Objective To compare the anesthesia effect and adverse effect of subarachnoid block anesthesia with different doses of sufentanil combined with bupivacaine 7.5 mg in aged patients,and explore the suitable dosage of sufentanil.Methods Eighty aged patients with ASA grade Ⅰ-Ⅲ undergoing elective lower limb surgery were divided into 4 groups by random digits table and each group was in 20 cases:group Ⅰ received bupivacaine 7.5 mg,group Ⅱ received bupivacaine 7.5 mg+sufentanil 2.5 μg,group Ⅲ received bupivacaine 7.5 mg+ sufentanil 5.0 μg,group Ⅳ received bupivacaine 7.5 mg+ sufentanil 7.5 μg.The vital signs,degree of motor and sensory nerve blockade and adverse effect were observed.Results Compared with base blood pressure,systolic blood pressure(SBP)and diastolic blood pressure(DBP)in group Ⅰ was significantly decreased after intrathecal injecton 15,30,45,60 minutes(P ＜0.05).There were no significant differences in the degree of motor nerve blockade in four groups(P ＞ 0.05).The time of sensory nerve blockade in group Ⅰ[(194 ± 58)min]was significantly shorter than that in group Ⅱ,Ⅲ,Ⅳ[(255 ±44),(242 ±58),(308 ± 123)min](P ＜0.05).The time of sensory nerve blockade in group Ⅳ was significantly longer compared with group Ⅱ and Ⅲ(P ＜ 0.05).The number of pruritus in group Ⅳ(10 cases)was significantly more than that in group Ⅰ and Ⅱ(0,4 cases)(P＜0.05).Conclusion Subarachnoid block anesthesia with sufentanil 2.5 or 5.0 μg combined with bupivacaine 7.5 mg in aged patients is safe and effective.