罗哌卡因复合不同剂量舒芬太尼骶管阻滞对肛肠手术后镇痛效果的影响

目的:观察罗哌卡因复合不同剂量舒芬太尼骶管阻滞对肛肠手术后镇痛效果的影响及不良反应的发生。方法:选择ASAⅠ～Ⅱ级肛肠手术患者60例,随机分为三组:对照组(C组),舒芬太尼1组(S1组),舒芬太尼2组(S2组),所有患者骶管穿刺成功后,给予试验剂量2%利多卡因3 ml,观察无并发症后,C组给予0.5%罗哌卡因20 ml,S1组给予0.5%罗哌卡因20 ml加5μg舒芬太尼,S2组给予0.5%罗哌卡因20 ml加10μg舒芬太尼。观察术后2、4、8、12、24 h各时点VAS评分,VAS评分≥3分,给予杜冷丁1mg/kg肌内注射,必要时重复给药;记录术后恶心、呕吐、瘙痒、尿储留例数及使用杜冷丁例数。结果:在第2、4、8、12 h时点VAS评分S1、S2组均低于C组(P<0.05),在第4、8小时VAS评分S2组低于S1组(P<0.05),C组使用杜冷丁例数多于其他两组(P<0.05),S2组尿储留和瘙痒的发生率明显高于其他两组(P<0.05)。结论:0.5%罗哌卡因复合5μg舒芬太尼骶管阻滞用于肛肠手术,能达到舒适有效的术后镇痛,值得临床推广。

Evaluate of ropivacaine combined with different doses of sufentanil using in caudal block on postoperative pain for anorectal operation

Objective To observe the efficacy and side reation of ropivacaine combined with different doses of sufentanil using in caudal block on postoperative analgesion for anorectal operation.MethodSixty patients ASAⅠ～Ⅱ undergoing elective anorectal operation were randomly divided into three groups(n=20): the control group(group C),sufentanil 1 group(group S1),sufentanil 2 group(group S2),and all patients underwent caudal block and gave test dose of 2% lidocaine 3 ml,if no complications occured,in group C gave 0.5% ropivacaine 20 ml,group S1 gave 0.5% ropivacaine 20 ml + 5 μg sufentanil,group S2 gave 0.5% ropivacaine 20 ml + 10 μg sufentanil.VAS score was evaluated at 2,4,8,12 and 24 h after the surgery.When VAS≥3,gave dolantin 1 mg/kg intramuscular,and when necessary,repeated to medicine.Recording postoperative nausea and vomiting,pruritus,urinary retention and the dolantin usage.ResultsIn group S1 and S2,VAS score was lower than that in group C at 2,4,8,12 h(P<0.05).At 4,8 h,VAS score in group S2 was lower than that in group S1(P<0.05).Dolantin usage number in group C was more than the other two groups(P<0.05).The incidence rate of postoperative nausea and vomiting,pruritus in group S2 was significantly higher than those of the other two groups(P<0.05).Conclusion0.5% ropivacaine combined with 5 ug sufentanil caudal block using could be a effective and comfortable method for postoperative analgesia in anorectal operation.