摘要
目的 探讨在老年下肢骨科手术的麻醉中罗哌卡因单腿腰麻效果。方法 选取2025年6月至12月收治的50例老年下肢骨折手术患者，随机分为观察组（罗哌卡因单腿腰麻）和对照组（连续硬膜外麻醉）各25例，对比感觉与运动阻滞指标、麻醉前后生命体征波动情况、不良反应、麻醉及围术期指标、疼痛情况。结果 观察组感觉、运动阻滞效果优于对照组（P<0.05）；麻醉后生命体征波动幅度显著小于对照组（P<0.05）；麻醉诱导时间更短、单位时间输液量更少，术后排气、住院时间及镇痛药物追加次数均优于对照组（P<0.05）；术后各时间点疼痛评分均低于对照组（P<0.05）；观察组不良反应总发生率8.00%，低于对照组28.00%（P<0.05）。结论 罗哌卡因单腿腰麻用于老年下肢骨科手术，麻醉阻滞效果更优，生命体征更平稳，围术期恢复更快，术后疼痛更轻，不良反应更少，更适合老年患者，临床推广价值高。
关键词： 老年下肢骨折手术；罗哌卡因；生命体征；单腿腰麻；不良反应
Abstract
Objective To explore the efficacy of ropivacaine single-leg spinal anesthesia in elderly patients undergoing lower limb orthopedic surgery. Methods Fifty elderly patients with lower limb fractures admitted between June and December 2025 were randomly divided into an observation group (ropivacaine single-leg spinal anesthesia) and a control group (continuous epidural anesthesia), with 25 patients in each group. Sensory and motor block indices, fluctuations in vital signs before and after anesthesia, adverse reactions, anesthesia and perioperative indicators, and pain levels were compared. Results The sensory and motor block effects in the observation group were superior to those in the control group (P<0.05); the amplitude of vital sign fluctuations after anesthesia was significantly smaller in the observation group (P<0.05); the anesthesia induction time was shorter, The volume of fluid infused per unit time was less, and postoperative flatus, hospital stay, and the number of additional pain medications were all better than those in the control group (P<0.05); pain scores at all postoperative time points were lower than those in the control group (P<0.05); the total incidence of adverse reactions in the observation group was 8.00%, which was lower than 28.00% in the control group (P<0.05). Conclusion Ropivacaine single-leg spinal anesthesia for elderly patients undergoing lower limb orthopedic surgery results in superior anesthesia block, more stable vital signs, faster postoperative recovery, less postoperative pain, and fewer adverse reactions, making it more suitable for elderly patients and highly valuable for clinical promotion.
Key words： Elderly lower limb fracture surgery; Ropivacaine; Vital signs; Single-leg spinal anesthesia; Adverse reactions
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