Objective To explore and analyze the anesthetic effects of different doses of ropivacaine combined with lidocaine for epidural anesthesia in elderly patients undergoing hysterectomy.Methods A total of 100 elderly patients who required hysterectomy in our hospital from April 2009 to June 2012 were randomly divided into the low dose group and the high dose group (n=50,each group).The low dose group was given 10 mg ropivacaine combined with lidocaine for lumbar epidural anesthesia,and the high dose group was given 15 mg ropivacaine combined with lidocaine for lumbar epidural anesthesia.The anesthetic effects in the two groups were observed.Results The onset time of sensory block and highest plane time were significantly shorter in high dose group than in low dose group [(159±21) s vs.(225±23) s,(7.3±1.3) min vs.(9.2±1.5) min,respectively,t=3.412 and 2.877,both P＜0.05)].The maintenance time of highest plane was significantly longer in high dose group than in low dose group [(57.3±8.1) min vs.(45.3±7.2)min,t=2.623,P＜0.05].The onset time of movement block was shorter in high-dose group than in low dose group[(4.3±1.2) min vs.(6.9±1.3) min,t=3.109,P＜0.05],while the maintenance time of movement was longer in high-dose group than in low dose group[(161 ± 16) min vs.(133 ±14) min,t=2.793,P＜0.05].There were no significant differences in modified Bromage Score between the two groups (P＞0.05).The excellent anesthetic effect was significantly higher in high dose group than in low dose group (90％ vs.80％,x2 =4.33,P＜0.05).There were no significant differences in the incidence of adverse reactions between the two groups (P＞0.05).Conclusions The application of 15 mg ropivacaine combined with lidocaine has a better anesthetic effect for lumbar epidural anesthesia in elderly patients undergoing hysterectomy.It can provide a reference for the clinical practice.

Objective To investigate the efficacy of remifentanil-propofol-atracurium combined general anesthesia for cesarean section.Methods One hundred and twenty ASA Ⅰ or Ⅱ parturients scheduled for elective cesarean section were enrolled in the study.Anesthesia was induced with iv injection of remifentanil 1.0 μg/kg,propofol 2.0 mg/kg and atracurium 0.4 mg/kg and maintained with iv infusion of remifentanil 9.0 μg· kg-1 · h-1,propofol 12.0 mg· kg-1 · h-1 and intermittent iv doses of atracurium 0.3 mg/kg.Hemodynamic parameters were recorded during anesthesia.Blood samples were taken from the umbilical artery after delivery for blood gas analysis.Apgar score and assessment of neonatal neurological behavior score were recorded.The emergence time,time of recovery of bowel function and intraoperative awareness were also recorded in parturients.Results The blood gas indexes,Apgar score and assessment of neonatal neurological behavior score in neonates and hemodynamic parameters during anesthesia in parturients were within the normal range.The emergence time was (5.0-± 0.5) min.No severe adverse reactions was found during the perioperative period.The postoperative followup showed that no intraoperative awareness occurred and the time of recovery of bowel function was (16.2 ± 0.7)h.Conclusion The efficacy of remifentanil-propofol-atracurium combined general anesthesia is good for cesarean section without obvious adverse effects on parturients and neonates.