本文關(guān)鍵詞： 硬膜外麻醉 老年 胸腰椎壓縮骨折 經(jīng)皮球囊椎體擴(kuò)張術(shù) 單次給藥　出處：《實(shí)用醫(yī)學(xué)雜志》2015年22期 　論文類型：期刊論文

【摘要】：目的:研究單次硬膜外麻醉在老年胸腰椎壓縮骨折患者經(jīng)皮球囊擴(kuò)張椎體成形術(shù)(PKP)中的應(yīng)用。方法:對2013年1月至2014年12月于硬膜外麻醉下行PKP的老年患者進(jìn)行回顧性研究。檢索患者一般情況、手術(shù)部位、硬膜外穿刺部位、穿刺操作時間、硬膜外用藥、麻醉阻滯范圍等。提取并分析麻醉前(T1)、穿刺后5 min(T2)、達(dá)到阻滯目標(biāo)時(T3)、手術(shù)開始時(T4)、手術(shù)開始后30 min(T5)及手術(shù)結(jié)束時(T6)的血壓和心率。結(jié)果 :共25例患者納入研究,其中23例患者應(yīng)用硬膜外麻醉,穿刺間隙與手術(shù)部位距離(1.8±1.2)個節(jié)段,應(yīng)用不同局麻藥的種類及容量分別為1%利多卡因+0.375%羅哌卡因(9.0±2.6)m L和1.5%利多卡因(8.9±3.0)m L。2例患者因硬膜外穿刺失敗改為腰麻。所有患者均達(dá)到滿足手術(shù)需要的阻滯范圍并順利完成手術(shù)。與T1相比,T2~T5時患者的平均壓均顯著降低(P0.05),以T3的平均壓最低(降低13.8%)。結(jié)論 :對行PKP的老年患者應(yīng)用單次硬膜外麻醉,麻醉平面可滿足手術(shù)要求,麻醉期間血流動力學(xué)較平穩(wěn)。
[Abstract]:Objective: to study the effect of single epidural anesthesia on percutaneous balloon dilatation vertebroplasty (PKP) in elderly patients with thoracolumbar compression fracture. Methods: a retrospective study was conducted on elderly patients with PKP under epidural anesthesia from January 2013 to December 2014. Surgical site, epidural puncture site, puncture operation time, epidural medication, anesthesia block, etc. Blood pressure and heart rate of T3, T4, T5 and T6 at the beginning of operation and at the end of operation. Results: a total of 25 patients were included in the study. 23 patients were treated with epidural anesthesia. The distance between the puncture space and the site of operation was 1.8 鹵1.2 segments. The types and volumes of different local anesthetics were 1% lidocaine 0.375% ropivacaine 9.0 鹵2.6 mL and 1.5% lidocaine 8.9 鹵3.0 respectively. ML.2 patients were treated with spinal anesthesia due to the failure of epidural puncture. All the patients achieved the range of block to meet the need of operation and completed the operation successfully, compared with T1. The mean pressure of T _ 2 / T _ 5 group was significantly lower than that of T _ 3 group, and the mean pressure of T _ 3 was the lowest (the decrease of 13.8%). Conclusion: single epidural anesthesia was used in the elderly patients with PKP. The level of anesthesia can meet the requirement of operation, and hemodynamics is stable during anesthesia.
【作者單位】： 北京大學(xué)腫瘤醫(yī)院暨北京市腫瘤防治研究所麻醉科惡性腫瘤發(fā)病機(jī)制及轉(zhuǎn)化研究教育部重點(diǎn)實(shí)驗(yàn)室;衛(wèi)生部北京醫(yī)院麻醉科;
【分類號】：R687.3
【正文快照】： 骨質(zhì)疏松性椎體壓縮骨折是常見的老年性疾病,經(jīng)皮球囊擴(kuò)張椎體成形術(shù)(percutaneouskyphoplasty,PKP)作為治療胸腰椎壓縮骨折的微創(chuàng)技術(shù)近年來得到迅速發(fā)展[1-3]。老年患者全身性生理功能降低,合并癥發(fā)生率高,麻醉風(fēng)險較大,如何為這類患者提供舒適、有效的麻醉,保證圍手術(shù)期安

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