老年硬膜外麻醉下阑尾切除术中精准麻醉理念的应用效果

席琳1 ，陈军2

（西安医学院附属宝鸡医院：1.麻醉科；2.骨一科，陕西 宝鸡，721006）

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摘要：

目的 分析老年硬膜外麻醉下阑尾切除术中精准麻醉理念的应用效果。方法 回顾性分析我院2016年1月至2016年12月收治的80例老年硬膜外麻醉下阑尾切除术患者的临床资料，根据不同麻醉剂量分为研究组与对照组，各40 例。两组患者 均给予T12~L1 间隙硬膜外穿刺，穿刺完成之后给予2%利多卡因5 mL 注入，5 min 后对相对阻滞平面予以测试，然后再将 0.5%罗哌卡因与0.67%利多卡因混合液予以注入，研究组注入剂量为5 mL，对照组注入剂量为10 mL，10 min 之后对绝对平 面予以测定。结果 注射基础剂量5 min 后，两组患者胸脊神经节段扩散节数比较，差异无统计学意义（P>0.05）；注射追加剂 量10 min 后，两组患者胸脊神经节段扩散节数比较，差异有统计学意义（P<0.05）；两组患者每毫升混合液增加的胸脊神经节 段比较，差异无统计学意义（P>0.05）。结论 老年硬膜外麻醉下阑尾切除术治疗过程中，通过注射基础剂量测得的阻滞平面 上界与T5 的距离，然后按照公式对追加剂量参考值进行计算，根据计算结果确定给药剂量，能够获取较为精准的阻滞平面。

关键词：硬膜外麻醉；阑尾切除术；精准麻醉理念

中图分类号：R614文献标志码：A文章编号：2096-1413(2017)32-0066-02

Application effect of precise anesthesia concept in elderly patients undergoing appendectomy with epidural anesthesia
XI Lin 1, CHEN Jun 2
(1. Department of Anesthesiology; 2. No.1 Department of Orthopedics, Baoji Affiliated Hospital of Xi``an Medical University, Baoji 721006, China)

ABSTRACT: Objective To analyze application effect of precise anesthesia concept in elderly patients undergoing appendectomy with epidural anesthesia. Methods The clinical data of 80 patients undergoing appendectomy with epidural anesthesia were retrospectively analyzed, all the patients were divided into study group and control group, with 40 cases in each group. Patients in the two groups were given T12-L1 gap epidural puncture; after the completion of the injection, 2% lidocaine 5 mL was injected, and the elative block plane was detected at 5 min later. Then the mixture of 0.5% ropivacaine and 0.67% lidocaine was injected, and the injection dose of the study group was 5 mL, and that of the control group was 10 mL, and the elative block plane was detected at 10 min later. Results There was no significant difference in thoracic spinal ganglion segment diffusion section number at 5 min after the basic dose injection between the two groups (P>0.05); but it had significant difference at 10 min after the boost dose injection (P<0.05); and there was no significant difference in thoracic spinal ganglion segment diffusion section number each milliliter mixture increased (P>0.05). Conclusion In elderly patients undergoing appendectomy with epidural anesthesia, to measure the distance between the upper bound and the T5 of the block plane by basic dose injection, and then to determine the dosage according to the calculation results can obtain more accurate blocking plane.
KEYWORDS: epidural anesthesia; appendectomy; precision anesthesia

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