{"title":"不同剂量罗哌卡因联合利多卡因硬膜外麻醉在老年骨科手术中的效果观察。","authors":"J Li, Q Yao, J Shi, P Jiang","doi":"10.1308/rcsann.2025.0055","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This paper unravelled the effectiveness of epidural anaesthesia induced by different dosages of ropivacaine combined with lidocaine in geriatric orthopaedic surgery.</p><p><strong>Methods: </strong>Elderly orthopaedic surgical patients who underwent epidural anaesthesia were allocated into three groups: Group I (0.375% ropivacaine+1% lidocaine), Group II (0.50% ropivacaine+1% lidocaine) and Group III (0.75% ropivacaine+1% lidocaine), to compare the sensory and motor blockade effects, the occurrence of cognitive function and cognitive dysfunction, and the occurrence of adverse reactions.</p><p><strong>Results: </strong>The onset time of sensory blockade and the appearance time of the highest plane were significantly earlier and the maintenance time of the highest plane was significantly longer, the onset time of motor blockade was notably earlier, the maintenance time of the highest plane was markedly longer, and the modified Bromage score was distinctly higher in Group II and Group III in comparison with Group I (<i>p</i><0.05). The postoperative 12- and 24-h Mini-Mental State Examination scores were higher and the incidence of postoperative 12h-cognitive impairment was lower in Group III than in Group I and Group II (<i>p</i><0.05). There was no statistically significant difference in the incidence of adverse reactions in patients among the three groups (<i>p</i>>0.05).</p><p><strong>Conclusions: </strong>Epidural anaesthesia combining 0.75% ropivacaine with 1% lidocaine in elderly orthopaedic surgical patients has a rapid onset of action, a long duration of anaesthesia maintenance, a low overall impact on cognitive function, and good medication safety.</p>","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of epidural anaesthesia induced by different dosages of ropivacaine combined with lidocaine in geriatric orthopaedic surgery.\",\"authors\":\"J Li, Q Yao, J Shi, P Jiang\",\"doi\":\"10.1308/rcsann.2025.0055\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This paper unravelled the effectiveness of epidural anaesthesia induced by different dosages of ropivacaine combined with lidocaine in geriatric orthopaedic surgery.</p><p><strong>Methods: </strong>Elderly orthopaedic surgical patients who underwent epidural anaesthesia were allocated into three groups: Group I (0.375% ropivacaine+1% lidocaine), Group II (0.50% ropivacaine+1% lidocaine) and Group III (0.75% ropivacaine+1% lidocaine), to compare the sensory and motor blockade effects, the occurrence of cognitive function and cognitive dysfunction, and the occurrence of adverse reactions.</p><p><strong>Results: </strong>The onset time of sensory blockade and the appearance time of the highest plane were significantly earlier and the maintenance time of the highest plane was significantly longer, the onset time of motor blockade was notably earlier, the maintenance time of the highest plane was markedly longer, and the modified Bromage score was distinctly higher in Group II and Group III in comparison with Group I (<i>p</i><0.05). The postoperative 12- and 24-h Mini-Mental State Examination scores were higher and the incidence of postoperative 12h-cognitive impairment was lower in Group III than in Group I and Group II (<i>p</i><0.05). There was no statistically significant difference in the incidence of adverse reactions in patients among the three groups (<i>p</i>>0.05).</p><p><strong>Conclusions: </strong>Epidural anaesthesia combining 0.75% ropivacaine with 1% lidocaine in elderly orthopaedic surgical patients has a rapid onset of action, a long duration of anaesthesia maintenance, a low overall impact on cognitive function, and good medication safety.</p>\",\"PeriodicalId\":8088,\"journal\":{\"name\":\"Annals of the Royal College of Surgeons of England\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-07-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of the Royal College of Surgeons of England\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1308/rcsann.2025.0055\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of the Royal College of Surgeons of England","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1308/rcsann.2025.0055","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Effectiveness of epidural anaesthesia induced by different dosages of ropivacaine combined with lidocaine in geriatric orthopaedic surgery.
Objective: This paper unravelled the effectiveness of epidural anaesthesia induced by different dosages of ropivacaine combined with lidocaine in geriatric orthopaedic surgery.
Methods: Elderly orthopaedic surgical patients who underwent epidural anaesthesia were allocated into three groups: Group I (0.375% ropivacaine+1% lidocaine), Group II (0.50% ropivacaine+1% lidocaine) and Group III (0.75% ropivacaine+1% lidocaine), to compare the sensory and motor blockade effects, the occurrence of cognitive function and cognitive dysfunction, and the occurrence of adverse reactions.
Results: The onset time of sensory blockade and the appearance time of the highest plane were significantly earlier and the maintenance time of the highest plane was significantly longer, the onset time of motor blockade was notably earlier, the maintenance time of the highest plane was markedly longer, and the modified Bromage score was distinctly higher in Group II and Group III in comparison with Group I (p<0.05). The postoperative 12- and 24-h Mini-Mental State Examination scores were higher and the incidence of postoperative 12h-cognitive impairment was lower in Group III than in Group I and Group II (p<0.05). There was no statistically significant difference in the incidence of adverse reactions in patients among the three groups (p>0.05).
Conclusions: Epidural anaesthesia combining 0.75% ropivacaine with 1% lidocaine in elderly orthopaedic surgical patients has a rapid onset of action, a long duration of anaesthesia maintenance, a low overall impact on cognitive function, and good medication safety.
期刊介绍:
The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November.
The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.