CAJ | 학술논문

目的观察皮下注射亚甲蓝、罗哌卡因复合液用于会阴部术后镇痛的EC95,并探讨最佳临床使用浓度.方法选取骶麻效果确切的180例混合痔、肛瘘、肛裂患者,术毕沿切缘皮下环形注射亚甲蓝、罗哌卡因复合液.前30例患者设定为Ⅰ组,按序贯试验法确定亚甲蓝的浓度,起始浓度为0.1%,相邻浓度比值为1.5,直至实验结束,用概率单位回归法计算EC95.后150例患者随机分为Ⅱ,Ⅲ,Ⅳ组,用作EC95及再上升两个浓度梯度间镇痛效果及副作用比较.结果亚甲蓝用于会阴部术后镇痛的EC95为0.105%,95%的可信区间为0.08%~0.137%.Ⅱ,Ⅲ,Ⅳ组均能达到即时和长效有效镇痛,平均VAS评分低于5分,Ⅱ组评分高于Ⅲ,Ⅳ组(P<0.05).Ⅳ组术后局部硬结、局部感觉异常的发生率高于前两组.结论亚甲蓝的EC95为0.105%,亚甲蓝、罗哌卡因混合液皮下环形注射用于会阴部术后具有良好的即时和长效镇痛效果,亚甲蓝的推荐使用浓度为0.15%.
목적 관찰피하주사아갑람、라고잡인복합액용우회음부술후진통적EC95,병탐토최가림상사용농도.방법 선취저마효과학절적180례혼합치、항루、항렬환자,술필연절연피하배형주사아갑람、라고잡인복합액.전30례환자설정위Ⅰ조,안서관시험법학정아갑람적농도,기시농도위0.1%,상린농도비치위1.5,직지실험결속,용개솔단위회귀법계산EC95.후150례환자수궤분위Ⅱ,Ⅲ,Ⅳ조,용작EC95급재상승량개농도제도간진통효과급부작용비교.결과 아갑람용우회음부술후진통적EC95위0.105%,95%적가신구간위0.08%~0.137%.Ⅱ,Ⅲ,Ⅳ조균능체도즉시화장효유효진통,평균VAS평분저우5분,Ⅱ조평분고우Ⅲ,Ⅳ조(P<0.05).Ⅳ조술후국부경결、국부감각이상적발생솔고우전량조.결론 아갑람적EC95위0.105%,아갑람、라고잡인혼합액피하배형주사용우회음부술후구유량호적즉시화장효진통효과,아갑람적추천사용농도위0.15%.
@@@@ Objective To research EC95 of the subcutaneous injection of methylene blue ,ropivacaine compound fluid preparation in postoperative analgesia of perineum ,and to explore the best concentration for clinical use .Methods One hundred and eighty cases of mixed hemorrhoid,anal fistula and anal fissure patients with exactly effect of sacral hemp were chosen ,methylene blue and ropivacaine com-pound fluid was injected along the cutting edge subcutaneous ring after surgery .First 30 patients were set to group Ⅰaccording to the sequen-tial test method to determine the concentration of methylene blue .Initial concentration was 0.1%,and the adjacent concentration ratio was 1. 5 until the end of the experiment .Probability unit regression method was used to calculate EC 95 .The latter 150 patients were randomly divided into groupⅡ,ⅢandⅣwith two concentration gradient interval ,and EC95 ,contrasting analgesia effect and side effects among the groups were measured.Results Methylene blue for postoperative analgesia of perineum EC 95 was 0.105%,and 95%confidence interval was 0.08%~0. 137%.Group Ⅱ,Ⅲ,Ⅳcan achieve the immediate and long-term effective analgesia,average VAS score was below 5 points,the score of groupⅡwas higher than group Ⅲ,Ⅳ(P<0.05).In group Ⅳthere was local callosity postoperatively ,and the local feel abnormal rate was higher than the previous two groups .Conclusion Methylene blue EC95 is 0.105%.Methylene blue and ropivacaine bromide mixture subcu-taneous ring injection used in perineum postoperative has good immediate and long -term analgesic effect.The recommended concentration of methylene blue is 0.15%.