노인 환자에서 고관절 전치환술을 위한 미추마취의 임상적 평가

Abstract

Caudal anesthesia for total hip replacement in geriatric patients has been evaluated clinically. The caudal epidural puncture was performed by a 22 G short needle through sacral hiatus with a lateral decubitus position. 1.5% lidocaine 20 mL and 0.5% bupivacaine 15 mL mixed with 1:200,000 epinephrine and 2 mg morphine was used as an anesthetics. The results were follows ; 1) The onset of caudal anesthesia was 7.9+/-4.5 min (2-20 min) and the duration was 4.8+/-3.0 hrs (1-12 hrs). 2) Anesthetic sensory level was not related with the patient's weight or height. 3) The failure rate including systemic toxicity was 13%. 4) The most common complication was hypotension and its incidence was 26.6%. 5) Time to first analgesics was 8.3+/-3.6 hrs. These results indicate that caudal anesthesia in lateral decubitus position is a recommendable anesthetic technique for total hip replacement in geriatric patients. However, the further studies for the determinations of the optimum dose of local anesthetics are needed.