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低剂量布比卡因-芬太尼联合腰麻:老年患者日间经尿道前列腺切除术的良好替代方案。

Spinal anesthesia with low-dose bupivacaine-fentanyl combination: a good alternative for day case transurethral resection of prostrate surgery in geriatric patients.

作者信息

Akcaboy Zeynep N, Akcaboy Erkan Y, Mutlu Nevzat M, Serger Nurten, Aksu Cuneyt, Gogus Nermin

机构信息

Department of Anesthesiology, Ankara Numune Training and Research Hospital, Ankara, Turkey.

出版信息

Rev Bras Anestesiol. 2012 Nov-Dec;62(6):753-61. doi: 10.1016/S0034-7094(12)70176-9.

Abstract

BACKGROUND AND OBJECTIVE

We evaluated the effectiveness, block duration, postanesthesia care unit stay and adverse effects of using intrathecal low dose bupivacaine and fentanyl combination and compared with conventional dose prilocaine and fentanyl combination for day case transurethral resection of prostate surgery in geriatric patient population.

MATERIALS AND METHODS

Sixty patients were randomized into two groups with Group B receiving 4 mg bupivacine 0.5%+25 μg fentanyl and Group P receiving 50 mg prilocaine 2%+25 μg fentanyl intrathecal. Block quality and duration, postanesthesia care unit stay and adverse effects were compared.

RESULTS

Block durations and postanesthesia care unit stay were shorter in Group B than in Group P (p<0.001 in both). Hypotension and bradycardia were not seen in Group B which was significantly different than in Group P (p=0.024 and p=0.011 respectively).

CONCLUSION

Intrathecal 4 mg bupivacaine + 25 μg fentanyl provided adequate spinal anesthesia with shorter block duration and postanesthesia care unit stay with stable hemodynamic profile than intrathecal 50 mg prilocaine + 25 μg fentanyl for day case transurethral resection of prostate surgery in geriatric patients.

摘要

背景与目的

我们评估了鞘内注射低剂量布比卡因与芬太尼联合用药的有效性、阻滞持续时间、麻醉后监护病房停留时间及不良反应,并与传统剂量丙胺卡因与芬太尼联合用药进行比较,用于老年患者日间经尿道前列腺切除术。

材料与方法

60例患者随机分为两组,B组鞘内注射4mg 0.5%布比卡因+25μg芬太尼,P组鞘内注射50mg 2%丙胺卡因+25μg芬太尼。比较两组的阻滞质量和持续时间、麻醉后监护病房停留时间及不良反应。

结果

B组的阻滞持续时间和麻醉后监护病房停留时间均短于P组(两者均p<0.001)。B组未出现低血压和心动过缓,与P组有显著差异(分别为p=0.024和p=0.011)。

结论

对于老年患者日间经尿道前列腺切除术,鞘内注射4mg布比卡因+25μg芬太尼比鞘内注射50mg丙胺卡因+25μg芬太尼能提供充分的脊髓麻醉,阻滞持续时间和麻醉后监护病房停留时间更短,血流动力学更稳定。

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