Epidural block with ropivacaine of small capacity and high concentrations combined with general anesthesia for elderly patients undergoing abdominal surgery

Objective To observe the effect of epidural block with ropivacaine of small capacity and high concentrations combined with general anesthesia that was used for elderly patients undergoing abdominal surgery.Methods Sixty elderly patients with ASA II～III undergoing abdominal surgery were randomly assigned into three groups: small capacity and high concentration group(H group),small capacity and normal concentration group(L group) and normal capacity and concentration group(C group).H group was given 0.75% of ropivacaine 2～3 ml in the epidural space,L group was given 0.25% of ropivacaine 2～3 ml and group C was given 0.25% of ropivacaine 6～8 ml at preoperation.Using 1% of seveflurine and propofol 4 mg.kg-1.h-1micro-pump to maintain anesthesia.According to the the hemodynamic changes,the phenylephrine or nitroglycerin was given duly,and the Rocuronium could be given if necessary.Results In the spinous process clearance of epidural puncture,there were no significant differences among the three groups(χ2=0.99,0.63,0.22,P0.05).The number of patients used phenylephrine of group C was significantly more than that of group H and group L(χ2=6.83,8.90,P0.05).The number of patients needed to add rocuronium before closing abdomen of group H was significantly less than that of group L and group C(χ2=6.53,3.91,P0.05).The time of spontaneous breathing recovery,pulling out the endotracheal tube and fully awake of group L and group C were significantly longer than that of the group H(t=2.76,3.97,2.42;2.07,2.77,2.76,P0.05).Conclusions Epidural block with ropivacaine of small capacity and high concentrations combined with general anesthesia for elderly patients undergoing abdominal surgery has advantage of hemodynamics,and patients awaken quickly at postoperative.