The Application Of Sufentanil Combined With Hypobaric Bupivacaine For Subarachnoid Anesthesia In The Elderly Patients Undergoing Lower Limb Surgery

Objective: Compared with the simple application of bupivacaine spinal anesthesia, to evaluate its effect and safety of subarachnoid block with hypobaric bupivacaine compounding sufentanil in the elderly patients undergoing lower limb surgery.Methods: Choose age 65-91 years old, weight 40-78 kg, ASAI-III, 60 cases with spinal epidural anesthesia for lower limb surgery were selected. All cases with double blind method were divided into three groups: Group A: 0.75% bupivacaine 10 mg; Group B: 0.75% bupivacaine 7.5 mg; Group C:0.75% bupivacaine 7.5mg and sufentainl 5ug,20 cases in each group, each case volume with sterile distilled water was 3 ml. Three groups were treated with spinal epidural combined anesthesia, limb upward, all patients were taken suffer from limb under the lateral recumbent position. Using a combination block matching in L3-4 gap puncture,, the cerebrospinal fluid outflow is the puncture success, then injected 3ml of drugs into subarachnoid space with the speed of 0.1 ml a second. Lateral 15 min after anesthesia is fixed on one side, and then placed in operative position. Observed and recorded the systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) and blood oxygen saturation(Sp O2). To record and evaluate the quality of anesthesia: the onset time of sensory block?the sensory block time of reached the highest level?the duration of sensory block?The onset time of motor block?the duration of motor block?the degree of motor block. Observe and record all patients with hypotension, nausea, vomiting, skin itching, chills and other adverse reactions.Results: 1.General: comparison of three groups of age, gender, height, weight, operation time length, the difference has no statistical significance(P > 0.05).2.After injection 10 min, 15 min, 30 min, in group A than that in group B and C of SBP, DBP, HR, the difference has statistical significance(P < 0.05).About Sp O2 of patients in the three groups at different time points, the difference has no statistical significance(P > 0.05). 3.The onset time of sensory block ?duration of sensory block and the sensory block time of reached the highest level, in group B than that in group A and C, the difference was statistically significant(P <0.05). 4. The duration of motor block and the degree of motor block, group A compared with B and C,the difference was statistically significant(P < 0.05). 5.The nausea and vomiting, chills, bradycardia adverse reaction in the three groups, the difference was not statistically significant(P >0.05). The incidence of pruritus in group C higher than A and B, A group of dopamine usage in patients were compared with B and C group, the difference was statistically significant(P < 0.05).Conclusion: Sufentainl 5 ug compounding with hypobaric bupivacaine 7.5 mg can prolong the effect of local anesthetics, block motor nerve slightly, reduce the local anesthetic drug and vascular active drug usage, reduce the adverse reactions. It is safety and useful in the elderly patients undergoing lower limb surgery.