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【目的】观察小剂量轻比重不同浓度罗哌卡因应用于腰硬联合麻醉老年全髋关节置换术中的效果。【方法】选择2014年6月至2015年6月本院收治的90例需行全髋关节置换术老年患者作为研究对象,按照配对分组法分为三组,均行 L3/4腰硬联合麻醉,A 组于蛛网膜下隙给予0.15%罗哌卡因3 mL,B 组给予0.2%罗哌卡因3 mL,C 组给予0.5%罗哌卡因3 mL,比较三组患者麻醉前(T0)、麻醉1 min(T1)、麻醉5 min(T2)、麻醉10 min(T3)、麻醉30 min(T4)及手术结束时(T5)血流动力学变化及麻醉效果。【结果】B 组 T1、T2、T3、T4时刻平均动脉压均高于 C 组,且两组相比较差异具有显著性(P <0.05)；B 组血流动力学更为平稳,T2、T3、T4时刻心率均低于 C 组,且两组相比较差异具有显著性(P <0.05)。B 组运动阻滞恢复时间均长于 A 组,低于 C 组,且两组相比较差异均具有显著性(P <0.05)；B 组运动阻滞起效时间长于 A 组,高于 C 组,且两组相比较差异均具有显著性(P <0.05)。A组、B 组不良反应发生率均低于 C 组,且两组相比较差异具有显著性(P <0.05)。【结论】0.2%罗哌卡因应用于腰硬联合麻醉老年全髋关节置换术中效果较佳,且不良反应发生率低,血流动力学平稳,具有临床使用价值。“,”Objective]To observe the effect of a small dose light proportion of different concentration ropiva-caine lateral combined spinal-epidural anesthesia when applied in the treatment of elderly patients with total hip ar-throplasty.[Methods]90 elderly patients with total hip arthroplasty treated in our hospital from July 2014 ~July 201 5 were selected as the research objects.Then,according to the paired grouping method,they were divided into three groups.All underwent lumbar 3~4 combined spinal and epidural anesthesia;Group A in the subarachnoid gap was given 3mL of 0.1 5% ropivacaine,group B was given 3ml of 0.2% ropivacaine,and Group C was treated with 3 mL 0.5% ropivacaine.The hemodynamic changes and the effects of anesthesia in patients of the three groups were compared.[Results]The mean arterial pressure of T1 ,T2 ,T3 ,and T4 in Group B was higher than that in group C;the difference was statistically significant,P <0.05.T2,T3 and T4 in Group B were lower than those in Group C,and the hemodynamics were more stable,P <0.05.The recovery time of patients in group B was longer than that of patients in Group A but shorter than that of patients in C Group;the onset time of the B Group was longer than that in the Groups A and C,(P <0.05).The incidence of adverse reactions in A Group and B Group was lower than that in C Group;the difference was statistically significant,P <0.05.[Conclusion]The application of 0.2% ropivacaine in the lumbar epidural anesthesia in total hip replacement in the elderly is best.Adverse reac-tions occurred rate is lower and hemodynamics is more stable,so it has important clinical value.