Anesthetic effects of combined different doses of ropivacaine and lidocaine for lumbar epidural anesthesia in elderly patients undergoing hysterectomy / 中华老年医学杂志

ABSTRACT

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.