肛肠外科中不同椎间隙硬膜外术后镇痛效果的比较

目的:观察肛肠外科中不同椎间隙硬膜外术后的镇痛效果。方法:肛肠外科手术患者100例,A SAⅠ~Ⅱ级,随机分为L4~5组和L5~S1组,每组50例,分别经L4~5、L5~S1椎间隙实施腰麻-硬膜外联合阻滞,在蛛网膜下腔注入0.5%罗哌卡因重比重液1~2ml,均向尾端置入硬膜外导管3~4cm,注入局麻药,连接止痛泵,内含0.2%罗哌卡因复合0.0003~0.0005%芬太尼100ml。结果:术后疼痛分级:L4~5组,0~1度占88%;L 5~S1组,0~1度占94%。结论:肛肠外科中,L5~S1椎间隙硬膜外术后镇痛的效果明显优于L4~5。

Comparison of the effect of different interspace PCEA in patients undergoing anus intestine surgery

Objective:To Compare the effect of different interspace PCEA in patients undergoing anus intestine surgery.Methods:100 ASAⅠ～Ⅱ patients undergoing anus intestine surgery were randomly divided into 2 groups,(n=50 each):L4～5 group and L5～S1 group.Undergoing combined spinal-epidural anesthesia in all.0.5% Ropivacaine hyperbaric solution 1～2 ml was injected into spinal.A catheter was inserted into the epidural space for 3～4 cm in a caudal direction.A test dose consisted of 5ml 2% lidocaine was given epidurally,5 minutes later,0.2% Ropivacaine 10ml followed.The PCEA setting was as follows:background infusion Ropivacaine 0.2% and fentanyl 0.0003～0.0005% at a rate of 2ml/h, bolus dose 1～2ml,lockout interval 15min.Results:Postoperation pain lever:L4～5group:88% in 0～1 degree;L5～S1 group: 94% in 0～1 degree.Conclusion:L5～S1 interspace PCEA is more effective than L4～5 in patients undergoing anus intestine surgery.