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椎管内麻醉
1、蛛网膜下腔阻滞:适用于会阴、下肢部位的短小手术。尤其是轻比重腰麻时,因药物浓度低(0.75%布比卡因或0.125%-0.2%罗哌卡因),对循环干扰小;腰麻后头痛发生率亦较年轻者低;特别是老年人的常见病如经尿道行前列腺电切除术甚为适宜。
2、连续硬脊膜外阻滞:可分次、小量给药,对血流动力影响小;术后可早期活动,减少术后肺部并发症。所以对老年病人有一定优点。但老年人的硬膜外腔相对小,故一次给药量应适当减少。
3、连续硬膜外阻滞加全身麻醉:全身麻醉可减少硬膜外阻滞时所需的辅助用药,而硬膜外阻滞具有良好的镇痛和肌松作用,可减少全麻药和肌松药的用量。对上腹部手术有一定优点。
Spinal canal anesthesia
1, subarachnoid block: suitable for perineal, extremities especially short of surgery. Especially light proportion, because waist hemp drug concentration low (0.75% cloth 0.125% - than lignocaine or 0.2% ROM perospirone lignocaine) of circular little interference, Lumbar hemp headache incidence after the younger also low; Especially the elderly of common diseases such as transurethral resection of the prostate is suitable for electrical lines.
2, the present continuous hard outside block: by installment, small dose of hemodynamic effects small; Postoperative can early activity, decrease postoperatie pulmonary complications. So in older patients have certain advantages. But the old of epidural cavity is relatively small, reason should be appropriately reduced to a drug.
3, continuous epidural block with general anesthesia: general anesthesia epidural blockade can reduce the need for auxiliary medicine, and epidural blockade has good analgesia and muscles loose function, can reduce the actions of general anesthetics and muscle relaxant dosage. Abdominal surgery on a certain advantages. |
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