不同浓度罗哌卡因蛛网膜下隙麻醉在肛肠手术中的应用

目的观察不同浓度罗哌卡因蛛网膜下隙麻醉在肛肠手术中的应用效果。方法 2017年8月-2019年5月,对A、B、C三组肛肠手术患者,选择不同浓度的罗哌卡因进行蛛网膜下隙阻滞麻醉,分别观察其麻醉起效时间、完善阻滞时间、持续阻滞时间及恢复时间;观察改良运动Bromage评分、镇痛效果和肛门肌松情况。得出最佳麻药浓度。结果 A、B组感觉阻滞起效时间、阻滞完善时间、术后镇痛时间优于C组,差异有统计学意义(P <0.05);改良运动Bromage评分、运动恢复时间B、C组优于A组,差异有统计学意义(P <0.05),B、C组差异无统计学意义(P> 0.05)。麻醉效果:A、B、C三组镇痛优良率为别为100.00%,98.86%,84.09%;肛门括约肌松弛率分别为100.00%,97.72%,82.95%;A、B两组比较差异无统计学意义(P> 0.05),A、B组与C组比较差异有统计学意义(P <0.05)。结论选择0.375%的罗哌卡因蛛网膜下隙阻滞麻醉,对肛肠手术的阻滞效果良好,运动恢复较快,肌松作用良好,且毒副反应较少。

Application of Different Concentrations of Ropivacaine in Subarachnoid Anesthesia in Anorectal Operation

Objective To observe the effect of different concentrations of ropivacaine in the application of subarachnoid anesthesia in anorectal surgery. Methods From August 2017 to May 2019, three groups of anorectal surgery patients, A, B and C, were anesthetized with different concentrations of ropivacaine for subarachnoid space block, and the onset time, perfect block time, continuous block time and recovery time of anesthesia were observed respectively, the Bromage score of improved exercise, analgesic effect and anal muscle relaxation were observed. Results The onset time, improvement time and postoperative analgesia time of sensory block in group A and group B were better than those in group C, the difference was statistically significant(P < 0.05). The improved exercise Bromage score and exercise recovery time in group B and group C were better than those in group A, the difference was statistically significant(P < 0.05), and there was no statistically significant difference between group B and group C(P > 0.05). Anesthesia effect: the excellent and good rate of analgesia in group A, B and C was 100.00%, 98.86%, 84.09% respectively;the relaxation rate of anal sphincter was 100.00%, 97.72%, 82.95% respectively;there was no statistically significant difference between group A and B(P > 0.05), and there was statistically significant difference between group A and B and group C(P < 0.05). Conclusion 0.375% ropivacaine in subarachnoid block anesthesia has good effect on anorectal operation, fast recovery of movement, good muscle relaxation and less side effects.