不同剂量及注药方向罗哌卡因对肛肠手术麻醉效果的影响

目的:研究不同剂量及注药方向罗哌卡因对肛肠手术麻醉效果的影响及安全性。方法:选择2015年1月~2016年12月在我院进行肛肠手术治疗的患者148例,按照麻醉方法的不同分为四组,每组各37例,即罗哌卡因8 mg向头注药组、罗哌卡因8mg向尾注药组、罗哌卡因10 mg向头注药组以及罗哌卡因10 mg向尾注药组。比较四组患者的感觉阻滞恢复时间、感觉阻滞起效时间以及运动阻滞恢复时间及恶心呕吐、尿潴留、腰部不适、头痛等术后不良反应的发生情况。结果:罗哌卡因10 mg向头注药与向尾注药的感觉阻滞起效时间比较差异均无统计学意义(P0.05),10 mg向头注药组的运动阻滞恢复时间明显短于10 mg向尾注药组(P0.05),以10 mg向头注药组感觉阻滞恢复时间最短(P0.05),8 mg向尾注药比10 mg向尾注药阻滞起效明显减慢(P0.05),运动以及感觉阻滞恢复时间均明显缩短(P0.05),10 mg向头注药组的感觉阻滞起效时间明显短于8 mg向头注药组(P0.05),运动以及感觉阻滞恢复时间均明显延长(P0.05)。四组均未发生恶心呕吐以及头痛等术后不良反应,罗哌卡因8 mg向尾注药组的尿潴留以及腰部不适的发生率均明显低于其他三组(P0.05)。结论:向尾端迅速注射罗帕卡因8 mg进行蛛网膜下隙阻滞对肛肠手术患者的麻醉效果最好,且安全性最高。

Effect of Different Doses and Directions of Ropivacaine Injection on the Anorectal Surgery

ABSTRACT Objective: To investigate the influence and safety of different doses and direction of ropivacaine injection on the anesthetic effect of anorectal surgery. Methods: 148 cases of patients with anorectal surgery who were treated in our hospital from January 2015 to December 2016 were selected and divided into four groups, 8 mg ropivacaine injection group, 8mgropivacaine on endnote medicine group, 10 mg ropivacaine injection group and 10 ropivacaine on endnote medicine group. The recovery time, the onset time of sensory block and motor block recovery time were compared between four groups; the adverse reaction of nausea and vomiting, urinary retention, waist discomfort, headache and other postoperative situations were compared. Results: There was no significant difference between the 10 mg ropivacaine injection and head to end note drug in the onset time of sensory block, motor block(P>0.05), the recovery time of 10 mg injection group and was significantly shorter than that of the 10 mg to endnote medicine group (P<0.05), the recovery of sensory block of 10 mg head injection group has the shortest time (P<0.05), the drug block onset on 8 mg tail injection group was decreased than that of the 10 mg tail injection group (P<0.05), the onset time of sensory block 10 mg head injection group was significantly shorter than that of the 8 mg head injection group (P<0.05), the motion and sensory block recovery time were significantly prolonged (P<0.05). There was no postoperative nausea and vomiting and headache adverse reactions between the four groups, the incidenceof urinary retentionand waist discomfort of ropivacaine 8 mg head injection group was significantly lower than that of the other three groups (P<0.05). Conclusion: Ropivacaine8 mg tail injection has significant clinical effect and less adverse reactions on patients with anorectal surgery, it could help to accelerate the recovery of patients.