Observation of low-dose ropivacaine combined with hydromorphone in elderly patients undergoing hip replacement surgery
MA Jian
LI Lin
YUE Dingxiong
ZHANG Kai
HU Zefan
LIU Hong
Abstract：Objective To investigate the efficacy and safety of low-dose ropivacaine combined with hydromorphone in elderly patients undergoing hip replacement surgery.Methods Ninety elderly patients aged 60-85 years,weighting 50-85 kg,ASA Ⅱ or Ⅲ,who underwent hip replacement surgery at Xiaogan First People's Hospital from January to December 2023,were selected.The patients were randomly divided into two groups according to random number table method:ropivacaine group(group A,n=44),ropivacaine+hydro-morphone group(group B,n=46).Group A was given ropivacaine 12 mg,and group B was given ropivacaine 7mg+hydromorphone 100 μg,which was mixed with the cerebrospinal fluid and diluted to 2 mL.The general conditions of the patients in both groups were com-pared.The changes of the mean arterial pressure(MAP)and heart rate(HR)before anesthesia(M1),1 minute after anesthesia(M2),5 minutes after anesthesia(M3),10 minutes after anesthesia(M4),and 15 minutes after anesthesia(M5)were observed and recorded.The recovery of motor nerves after surgery(using Bromage exercise score),the occurrence of hypotension,nausea and vomiting,urinary retention,perineal pruritus,respiratory depression and other adverse reactions were observed and recorded.Results The comparison of anesthesia levels between the two groups of patients showed that both group A and group B had anesthesia levels above T10 level of spinal nerve,which met the surgical requirements.However,there were more patients whose anesthesia level reached T8 and T9 level of spinal nerve in group A than those in group B,and the difference was statistically significant(P＜0.05);there was no statistically significant difference in MAP and HR before anesthesia(P＞0.05),while the comparison of MAP and HR at M2,M3,M4,M5,showed that group A was lower than group B,and the difference was statistically significant(P＜0.05);after the surgery,Bromage motor scores of group B were lower than those of group A,and the difference was statistically significant(P＜0.05);in terms of adverse reactions,the incidence of hypotension and urinary retention in group A was significantly higher than that in group B,and the incidence of perineal pruritus in group B was significantly higher than that in group A(P＜0.05).Conclusion Low dose and low concentration ropivacaine combined with hydromorphone can achieve good analgesic effect,stable hemodynamics,fast recovery of motor nerves,and low incidence of anesthesia adverse reactions in elderly patients undergoing hip replacement.
Keywords：ropivacaine hydrochloridehydromorphone hydrochloridehip replacement surgery for elderly patientsefficacy and safety
Publication Date：2025-02-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 28-31 )