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 Wysłany: Śro 1:30, 23 Mar 2011 Temat postu: tory burch outlet Small dose of local anesthetic i |
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Small dose of local anesthetic in elderly patients Clinical observation of spinal anesthesia
Clinical effect of spinal anesthesia Tengjin Liang Xiong Zhao Lihong Zhao Yongquan Stone (Hebei North University Department of Anesthesiology, First Affiliated Hospital, Zhangjiakou, Hebei 075000) 【Key Words】 B 1R614 【Document code article number】 【l673-1484 (2006) 05 - 0046-0l elderly patients with cardiovascular dysfunction, and often associated with hypertension, coronary heart disease and cerebral vascular sclerosis and other diseases, cardiovascular reserve function decline. In what is conducive to surgical anesthesia,[link widoczny dla zalogowanych], but also for elderly patients to adverse cardiovascular effects for less anesthesia profession has been subject to peer attention. We analyzed 54 cases of elderly patients through the implementation of low-dose spinal anesthesia with local anesthetic clinical data of elderly patients with small-dose spinal anesthesia local anesthetic effect and safety. 1 Methods 54 patients undergoing elective surgery, including hip surgery in 28 cases, 26 cases of prostate surgery. Male patients in this group 33 cases, 21 women,[link widoczny dla zalogowanych], aged 7O ~ 86 years old,[link widoczny dla zalogowanych], ASAI ~ Ⅲ. Monitoring of blood pressure in patients with one operating room (Bp), pulse oxygen saturation (SpOz) and ECG. After opening the peripheral vein, the side into the subarachnoid puncture method, see the cerebrospinal fluid outflow, the injection of bupivacaine 6.0 0.5 9. Omg. Measured within 5min block level, the control of anesthesia in the appropriate range. Conventional intraoperative oxygen mask or nasal catheter, the SpO. Maintained within the normal range. Systolic blood pressure fell below 90mmHg or lower than those before anesthesia 3O decreased as blood pressure,[link widoczny dla zalogowanych], appropriate intravenous fluids and ephedrine as appropriate, for processing. 2 Results 54 patients after spinal anesthesia level up to T. ~. . , The exact effect of anesthesia, surgery were not used throughout the analgesic, sedative and other auxiliary drugs. 54 cases of anesthesia throughout the patient have different levels of blood pressure, the time of hypotension after injection of local anesthetic in 18 ~ 20min, which dropped by more than 11 cases of systolic blood pressure levels before surgery 3O, rehydration by speeding up the speed, using ephedrine lO ~ 20mg and other treatment to restore normal range. 3 Discussion of hip fracture and benign prostatic hyperplasia and other diseases have become a frequently-occurring disease in elderly patients. To improve the quality of life of older persons, to become the preferred surgical treatment. However, the elderly and morphological changes in cardiovascular function, such as vascular degeneration, heart degeneration, and abnormal blood pressure fluctuations, greatly increasing the difficulty of anesthesia. With the older structure and function of the cardiovascular system occur degeneration of aging, the heart of the reserve be reduced accordingly. At the same time more than the elderly with hypertension, coronary heart disease, diabetes and other diseases, anesthesia and surgery on tolerance to decrease, when the effective circulating blood volume changes occurring compensatory function decreased significantly, prone to hypotension-lj. Cycle management of anesthesia in elderly patients is to adopt the principle of minimal inhibition of recycling methods and drugs,[link widoczny dla zalogowanych], as protection of the compensatory function of the cardiovascular system, and promptly correct the anomaly. Actively carry out preparatory work before surgery, to correct water and electrolyte disturbance, as the blood pressure and blood sugar control to near normal range of indicators to improve myocardial blood supply and improve the tolerance of anesthesia. Spinal anesthesia is simple, rapid onset of analgesia improve the advantages of [2], patients and surgeons willing to accept. However, due to the implementation of conventional dose spinal anesthesia with local anesthetic hemodynamics greater impact on patients, often sharp drop in blood pressure, circulatory and respiratory depression, or even result in serious consequences for elderly patients even more significant, therefore subject to certain limitations of clinical application . We implemented the use of small doses of local anesthetic used in 54 cases of spinal anesthesia in elderly patients, the exact effect of anesthesia, intraoperative blood pressure, although there are different degrees of decline, but significantly decreased blood pressure accounted for only 23.7, far lower than reported in the literature. These results suggested that the implementation of a small dose of local anesthetic used in spinal surgery in elderly patients safe.
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