摘要
目的探讨采用不同剂量舒芬太尼复合罗哌卡因可行走腰麻在肛肠手术中的应用价值。方法便利选取该科室2018年3月-2019年3月收治行可行走腰麻肛肠手术患者(疾病类型:痔疮、肛瘘、肛周脓肿、肛裂)60例进行分析,按照随机数字表法分为3组,各纳入患者20例,A组给予罗哌卡因4.5 mg,B组给予罗哌卡因4.5 mg+舒芬太尼1.5μg,C组给予罗哌卡因4.5 mg+舒芬太尼3.0μg,行L3~4椎间隙鞘内注射。观察比较3组患者麻醉后不同时刻的肛周针刺疼痛评分(VAS量表),疼痛消失起效时间和维持时间,下肢运动改良情况(Bromage评分),并观察与统计两组的不良反应。结果随着复合舒芬太尼剂量的增加,VAS评分显著更低,C组3、5、10、15 min的VAS评分分别为(1.4±0.5)分,(0.06±0.3)分,(0.03±0.01)分,(0.01±0.01)分,均显著低于A组与B组(P<0.05);随着舒芬太尼剂量的增加,起效时间明显缩短,并且维持时间则更长,C组起效时间、维持时间分别为(3.9±1.2)min和(92.8±8.1)min;3组患者对于下肢运动阻滞程度很轻,可行走率均达到100.0%。统计各种不良反应发生情况,仅皮肤瘙痒的发生率随着舒芬太尼剂量的增加而增加,C组皮肤瘙痒共计5例,显著高于A组(P<0.05)。结论舒芬太尼3.0μg复合罗哌卡因用于可行走腰麻肛肠手术中可以获得满意的麻醉效果。
Objective To explore the application value of walking lumbar anesthesia with different doses of sufentanil combined with ropivacaine in anorectal surgery. Methods 60 patients(hemorrhoids, anal fistula, perianal abscess, anal fissure)who underwent lumbar anesthesia and anorectal surgery in the department from March 2018 to March 2019 were convenient selected for analysis. They were divided into three groups according to the random number table method, with 20 patients in each group. Group A was treated with ropivacaine 4.5 mg, Group B with ropivacaine 4.5 mg + sufentanil 1.5 μg, and Group C with ropivacaine 4.5 mg + sufentanil 3.0 μg. L3 ~4 intervertebral space intrathecal injection was performed. The VAS scale, the onset and maintenance time of pain disappearance and the Bromage score of lower limb movement improvement were observed and compared at different time after anesthesia in the three groups, and the adverse reactions of the two groups were observed and counted. Results With the increase of compound sufentanil dosage, the VAS score was significantly lower. The VAS score of group C at 3, 5, 10 and 15 minutes was(1.4±0.5)points,(0.06±0.3)points,(0.03±0.01)points,(0.01±0.01) points respectively, which was significantly lower than that of group A and group B(P<0.05). With the increase of sufentanil dosage, the onset time was significantly shorter and the maintenance time was longer, while the onset time and onset time of group C were longer. The duration of maintenance was(3.9±1.2) min and(92.8±8.1) min. The degree of lower limb motor block in the three groups was very mild, and the walking rate was 100.0%. The incidence of skin pruritus increased with the dose of sufentanil. There were 5 cases of skin pruritus in group C, which was significantly higher than that in group A(P<0.05). Conclusion Sufentanil 3.0 UG combined with ropivacaine can achieve satisfactory anesthesia effect in walking lumbar anesthesia and anorectal surgery.
作者
李志强
LI Zhi-qiang(Department of Anesthesiology,Jiangyin People's Hospital,Southeast University Medical College,Jiangyin,Jiangsu Province,214400 China)
出处
《中外医疗》
2020年第3期115-117,共3页
China & Foreign Medical Treatment
关键词
肛肠手术
不同剂量
舒芬太尼
罗哌卡因
麻醉效果
Anorectal surgery
Different doses
Sufentanil
Ropivacaine
Anesthesia effect
