目的 研究低密度盐酸罗哌卡因单侧腰麻对老年人髋部手术血流动力学和不良反应的影响。方法 选取进行髋部手术的老年患者98例为研究对象,随机分成两组,各49例。给予对照组患者高密度盐酸罗哌卡因腰麻,给予观察组患者低密度盐酸罗哌卡因腰麻。记录麻醉前后患者MAP、HR反映血流动力学变化。记录感觉阻滞、麻醉起效时间、维持时间等评价麻醉效果,同时记录不良反应。结果 观察组的麻醉起效时间、阻滞时间、麻醉持续时间均短于对照组,差异有统计学意义（P<0.05）;对照组Bromage分级评分为（2.13±0.86）分,观察组为（2.89±0.23）分,差异有统计学意义（P<0.05）;麻醉后运动阻滞对照组起效慢于观察组,观察组麻醉维持时间比对照组更长,差异有统计学意义（P<0.05）;观察组麻醉后MAP下降趋势小于对照组,不良反应发生率低于对照组,差异均有统计学意义（P<0.05）。结论 低密度盐酸罗哌卡因单侧腰麻用于老年髋部手术具有起效迅速、麻醉持续时间长、镇痛完善、不良反应低,对血流动力学影响较小等临床优点,值得广泛推广。

Objective To analyze the effect of unilateral lumbar anesthesia with hypobaric ropivacaine hydrochloride on hemodynamic parameters and incidences of adverse reactions in elderly patients with hip surgery. Methods A total of 98 elderly patients undergoing hip surgery in our hospital were selected and randomly divided into two groups, with 49 cases in each group. The control group were given hyperbaric ropivacaine hydrochloride for spinal anesthesia, while the experimental group were given hypobaric ropivacaine hydrochloride. Then, the hemodynamic changes （MAP and HR） before and after anesthesia, sensory block, onset time and maintenance time of anesthesia, as well as the incidences of adverse reactions of patients were recorded. Results The onset time, block time, and maintenance time of anesthesia of the experimental group were shorter than those of the control group （P<0.05）. The Bromage score of the control group was 2.13±0.86 and that of the experimental group was 2.89±0.23, and the difference was statistically significant （P<0.05）. After anesthesia, the onset of motor block of the control group was slower than that of the experimental group, and the maintenance of anesthesia of the experimental group was longer than that of the control group （P<0.05）. After anesthesia, the experimental group showed less declines in MAP and lower incidences of adverse reactions than the control group did （P<0.05）. Conclusion Unilateral spinal anesthesia with hypobaric ropivacaine hydrochloride features quick onset, long duration of anesthesia, perfect analgesia, few side effects, and few hemodynamic changes in elderly hip surgery, thus it is worth promoting.