中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2014年
16期
104-106
,共3页
布比卡因%肛周手术%蛛网膜下腔阻滞麻醉%运动阻滞%尿潴留
佈比卡因%肛週手術%蛛網膜下腔阻滯痳醉%運動阻滯%尿潴留
포비잡인%항주수술%주망막하강조체마취%운동조체%뇨저류
Bupivacaine%Perianal surgery%Subarachnoid anesthesia%Motor block%Urinary retention
目的：探讨不同剂量布比卡因蛛网膜下腔阻滞麻醉在肛周手术中的应用效果，以探讨最佳麻醉剂量。方法选择本院2012年4月~2013年12月蛛网膜下腔阻滞麻醉下行肛周手术的患者96例，随机分为3组，每组各32例，A组采用0.5%布比卡因2.0 ml麻醉，B组采用0.5%布比卡因1.5 ml麻醉，C组采用0.5%布比卡因1.0 ml麻醉，观察3组患者的麻醉起效时间、麻醉效果、术后运动阻滞情况及并发症发生情况。结果3组患者的感觉阻滞起效时间、麻醉优良率比较，差异无统计学意义(P>0.05)，术毕时C组患者运动阻滞均为0~Ⅰ级(100.0%)，A、B组下肢运动阻滞0~Ⅰ级者分别占12.5%、31.2%，明显低于C组，组间比较差异均有统计学意义(P<0.05)，且C组尿潴留发生率明显低于A、B组，差异有统计学意义(P<0.05)。结论肛周手术中采用0.5%布比卡因1.0 ml蛛网膜下腔阻滞麻醉，在保证麻醉效果的同时，能够有效减轻术后下肢运动神经阻滞，避免术后尿潴留，可作为肛周手术的最佳麻醉剂量。
目的：探討不同劑量佈比卡因蛛網膜下腔阻滯痳醉在肛週手術中的應用效果，以探討最佳痳醉劑量。方法選擇本院2012年4月~2013年12月蛛網膜下腔阻滯痳醉下行肛週手術的患者96例，隨機分為3組，每組各32例，A組採用0.5%佈比卡因2.0 ml痳醉，B組採用0.5%佈比卡因1.5 ml痳醉，C組採用0.5%佈比卡因1.0 ml痳醉，觀察3組患者的痳醉起效時間、痳醉效果、術後運動阻滯情況及併髮癥髮生情況。結果3組患者的感覺阻滯起效時間、痳醉優良率比較，差異無統計學意義(P>0.05)，術畢時C組患者運動阻滯均為0~Ⅰ級(100.0%)，A、B組下肢運動阻滯0~Ⅰ級者分彆佔12.5%、31.2%，明顯低于C組，組間比較差異均有統計學意義(P<0.05)，且C組尿潴留髮生率明顯低于A、B組，差異有統計學意義(P<0.05)。結論肛週手術中採用0.5%佈比卡因1.0 ml蛛網膜下腔阻滯痳醉，在保證痳醉效果的同時，能夠有效減輕術後下肢運動神經阻滯，避免術後尿潴留，可作為肛週手術的最佳痳醉劑量。
목적：탐토불동제량포비잡인주망막하강조체마취재항주수술중적응용효과，이탐토최가마취제량。방법선택본원2012년4월~2013년12월주망막하강조체마취하행항주수술적환자96례，수궤분위3조，매조각32례，A조채용0.5%포비잡인2.0 ml마취，B조채용0.5%포비잡인1.5 ml마취，C조채용0.5%포비잡인1.0 ml마취，관찰3조환자적마취기효시간、마취효과、술후운동조체정황급병발증발생정황。결과3조환자적감각조체기효시간、마취우량솔비교，차이무통계학의의(P>0.05)，술필시C조환자운동조체균위0~Ⅰ급(100.0%)，A、B조하지운동조체0~Ⅰ급자분별점12.5%、31.2%，명현저우C조，조간비교차이균유통계학의의(P<0.05)，차C조뇨저류발생솔명현저우A、B조，차이유통계학의의(P<0.05)。결론항주수술중채용0.5%포비잡인1.0 ml주망막하강조체마취，재보증마취효과적동시，능구유효감경술후하지운동신경조체，피면술후뇨저류，가작위항주수술적최가마취제량。
Objective To investigate effect of different doses of bupivacaine subarachnoid anesthesia in perianal surgery,and investigate the best anesthetic dose. Methods 96 patients who were given perianal surgery under subarach-noid anesthesia in our hospital from April 2012 to December 2013 were randomly divided into three groups,32 cases in each group,the dose of 0.5% bupivacaine in group A,group B group,C were 2.0,1.5,1.0 ml respectively,the onset time, anesthesia effect,postoperative motor block and complications of three groups were observed. Results The sensory block onset time and anesthesia excellent rate of three groups were compared,the difference was not significant (P>0.05),at the end of surgery,motor block level of group C were all in class 0-I (100.0%),and the patients with motor block level in 0-I class in group A,group B accounted for 12.5%,31.2% respectively,significantly lower than group C,the differ-ences were significant (P<0.05),the urinary retention rate in group C was significantly lower than that in group A,group B,the difference was significant (P<0.05). Conclusion In perianal surgery,subarachnoid anesthesia with 0.5% bupiva-caine 1.0 ml can ensure anesthetic effect,at the same time can effectively reduce postoperative lower limb motor block, avoid postoperative urinary retention,can be suggested as the best anesthesia dose in perianal surgery.
