So sánh tác dụng của gây tê tủy sống bằng ropivacain với bupivacain trong phẫu thuật thay khớp gối ở người già tại Bệnh viện Hữu nghị Việt Đức=Comparison of the clinical effects of intrathecal ropivacain and bupivacain in geriatric patients undergoing knee arthroplasty at Viet Duc University Hospital

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Tác giả: Văn Sỹ Đặng, Thị Kim Dung Đào

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.220-227

Bộ sưu tập: Metadata

ID: 477586

Thêm vào giỏ

So sánh tác dụng vô cảm và tác dụng không mong muốn của gây tê tủy sống bằng ropivacain với bupivacaine trong phẫu thuật thay khớp gối ở người già. Đối tượng và phương pháp nghiên cứu: Thử nghiệm lâm sàng ngẫu nhiên có đối chứng trên 60 bệnh nhân người già được phẫu thuật thay khớp gối bằng gây tê tủy sống, chia hai nhóm bằng nhau. Nhóm R (10mg Ropivacain+ 30 μg fentanyl), nhóm B (7mg Bupivacain+ 30 μg fentanylThu thập: Mức phong bế cảm giác, vận động, huyết động, tác dụng không mong muốn. Kết quả: Mức độ ức chế cảm giác trung bình ở 2 nhóm là như nhau, nhưng thời gian khởi phát ức chế cảm giác ở nhóm B (2.52 ± 0.69 phút) ngắn hơn so với nhóm R (3.17±0.72 phút), sự khác biệt có ý nghĩa thống kê (p <
0.01), số lượng bệnh nhân đạt phong bế vận động Bromage 3 ở nhóm B (25) cao hơn so với nhóm R (16). Không có sự khác biệt về thay đổi huyết áp trung Binh, nhịp tim, SpO2 giữa 2 nhóm. Nhịp tim chậm xuất hiện ít hơn ở nhóm R so với nhóm B, không có biến chứng thần kinh nào được ghi nhận ở 2 nhóm. Kết luận: Liều gây tê tủy sống là 10mg ropivacain so với 7mg bupivacaine đảm bảo đủ phong bế cảm giác, vận động trong mổ thay khớp gối ở người già. Gây tê tủy sống bằng ropivacain cũng đảm bảo hiệu quả và an toàn so với gây tê tủy sống bằng bupivacaine ở người già.The aim of this study was to compare the anaesthetic effects and side effects of ropivacaine and bupivacaine in spinal anaesthesia for knee arthroplasty in geriatric patients. Subjects and Methods: A randomized, placebo-controlled trial was conducted in which 60 eldery patients undergoing knee arthroplasty by spinal anesthesia were assigned to receive an intrathecal injection of either 10 mg ropivacaine with 30 μg fentanyl (group R) or 7 mg bupivacaine with 30 μg fentanyl (group B). Motor and sensory block, haemodynamics and side effects were recorded. Results: Mean levels of sensory block were similar, but the onset time of sensory block in group B (2.52 ± 0.69 min) was shorter than that in group R (3.17±0.72 min)
the difference was statistically significant (p <
0.01), and the number of patients who had motor Bromage scale 3 in group B (25) was greater than in group R (16). The difference was also statistically significant (p <
0.05). The variations in mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2) in the course of time were similar in the groups. When the side effects of the two groups were compared, bradycardia was found to be significantly lower in Group R than in Group B. No neurological problems were observed in any patients. Conclusions: 10 mg of ropivacaine and 7 mg of bupivacaine with 30 μg fentanyl in spinal anaesthesia can provide sufficient motor and sensory block for knee arthroplasty in geriatric patients. Intrathecal ropivacain is as effective and safe as intrathecal bupivacaine in geriatric patients.

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