Clinical study on micropump continuous drug administration epidural anesthesia in elderly patients with total hip replacement
10.3969/j.issn.1671-8348.2017.31.019
- VernacularTitle:微量泵持续给药硬膜外麻醉用于高龄患者全髋关节置换术的临床研究
- Author:
Juan LIU
1
;
Jibing DING
;
Jiaguo LIN
Author Information
1. 重庆市奉节县人民医院麻醉科 404600
- Keywords:
epidural anesthesia;
aged;
total hip replacement;
sustained drug delivery
- From:
Chongqing Medicine
2017;46(31):4375-4377
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the application effects of different drug administration modes under continuous epidural anesthesia in elderly patients undergoing total hip replacement.Methods One hundred and twelve ASA Ⅱ-Ⅲelderly patients undergoing elective total hip replacement,55 males and 57 females,aged 75-91 years old,were randomly divided into the group A and B,56 cases in each group.After continuous epidural puncture success at L2-L3,the test dose of 2 ％ lidocaine 3 mL was injected,according the anesthesia plane,additional 2 ％ lidocaine 3-5 mL was injected,the group A adjusted the anesthesia plane to T10,after fixation,epidural continuous infusionof 2 ％ lidocaine 3 5 mL/h was performed according to the patient's condition;the group B adjusted the anesthesia plane to T10,after fixation,according to patient's condition epidural injection of 2 ％ lidocaine 3-5 mL/h was injected by several times.The two groups were given vasoactive drugs dopamine when necessary during operation.Mean arterial pressure(MAP),heart rate (HR) and pulse oxygen saturation (SPO2) at entering the operation room,30 min after medication injection,skin incision,postoperative 1 h and end of operation were recorded in the two groups.The anesthesia plane,anesthetic drug dosage,anesthesia effect and fotal dosage of dopamine were recorded in the two groups.Results Blood pressure after epidural drug administration in the two groups were significantly reduced,while the blood pressure after intraoperatively administrating additional drug in the group B was significantly decreased compared with the group A(P＜0.05).The anesthesia plane in the group A was more stable than that in the group B (P＜0.01),moreover the dosage of anesthetic drug was decreased significantly (P＜0.05).The intraoperative total amount of dopamine in the group A was obviously less than that in the group B (P＜0.05).Conclusion Micropump continuous drug administration during continuous epidural anaesthesia has little influence on the patient's hemodynamics than discontinuous single drug administration.In the condition without affecting the anesthesia effect,the anesthesia plane is more stable,the anesthesia drug dose can be significantly decreased,which is conducive to maintain the circulation stable and increase perioperative safety.
