CAJ | 학술논문

目的：分析比较不同剂量利多卡因复合芬太尼在成人鞍区手术骶管阻滞中的麻醉和镇痛效果。方法分析我院自2012年1月～2014年4月收治的行肛门、会阴部手术的患者102例，均行鞍区手术且给予成人骶管阻滞麻醉。102例患者随机分为治疗组54例与对照组48例。对照组给予1.5％的利多卡因20～25mL，治疗组给予1.5％的利多卡因10～15mL。观察两组麻醉效果、术后24h内VAS评分及副反应。结果两组麻醉起效时间、维持时间、痛觉消失时间比较差异无统计学意义（P＞0.05）；两组患者术2h的VAS评分比较差异有统计学意义（P＜0.05），术后4、8、16、24h的VAS评分比较差异无统计学意义（P＞0.05）；两组患者呼吸抑制、恶心呕吐、尿潴留等不良反应发生率比较差异有统计学意义（P＜0.05），麻醉阻滞不全、血压降低发生率比较差异无统计学意义（P＞0.05）。结论小剂量利多卡因复合芬太尼与大剂量利多卡因组比较，不影响麻醉效果，对与术后VAS评分也无显著影响，不增加镇痛药的应用，且减少不良反应的发生，有临床推广应用的价值。
목적：분석비교불동제량리다잡인복합분태니재성인안구수술저관조체중적마취화진통효과。방법분석아원자2012년1월～2014년4월수치적행항문、회음부수술적환자102례，균행안구수술차급여성인저관조체마취。102례환자수궤분위치료조54례여대조조48례。대조조급여1.5％적리다잡인20～25mL，치료조급여1.5％적리다잡인10～15mL。관찰량조마취효과、술후24h내VAS평분급부반응。결과량조마취기효시간、유지시간、통각소실시간비교차이무통계학의의（P＞0.05）；량조환자술2h적VAS평분비교차이유통계학의의（P＜0.05），술후4、8、16、24h적VAS평분비교차이무통계학의의（P＞0.05）；량조환자호흡억제、악심구토、뇨저류등불량반응발생솔비교차이유통계학의의（P＜0.05），마취조체불전、혈압강저발생솔비교차이무통계학의의（P＞0.05）。결론소제량리다잡인복합분태니여대제량리다잡인조비교，불영향마취효과，대여술후VAS평분야무현저영향，불증가진통약적응용，차감소불량반응적발생，유림상추엄응용적개치。
Objective To analyze and compare the different doses of lidocaine and fentanyl in anesthesia and analgesia effect of block in the sellar region sacral surgery in adults.Methods 102 cases of anus and perineal operation in our hospital from 2012 January to 2014 April received operation of sellar region and gave the adult sacral anesthesia. 102 patients were randomly divided into treatment group 54 cases and control group of 48 cases. The control group was given 1.5% lidocaine 20 to 25mL, the treatment group was given 1.5% lidocaine 10 to 15mL.The effect of anesthesia, the VAS score after 24h and side reaction of two groups were observed.Results The onset time of anesthesia, the maintain time, pain free time of two groups was not significant (P>0.05). The VAS scores in 2h were statistically significant (P<0.05), and the VAS scores after 4h, 8h, 16h, 24h showed no statistical significance (P>0.05). The adverse reactions of respiratory depression, nausea and vomiting, urinary retention of two groups were significant difference(P<0.05), there was no statistical significance in incidence rate of block anesthesia and blood pressure lowering (P>0.05).Conclusion A small dose of lidocaine and fentanyl compared with large dose of lidocaine group, does not affect the effect of anesthesia, also had no significant effect on the score and postoperative VAS, not to increase the application of analgesics, and reduce the incidence of adverse reactions, has clinical application value.