不同剂量布比卡因蛛网膜下腔阻滞麻醉在肛周手术中的效果评价  

Effect evaluation of different doses of bupivacaine subarachnoid anesthesia in perianal surgery

作　　者：杜玉恒[1] 胡明玉[2] 

机构地区：[1]济南市长清区人民医院麻醉科,济南250300 [2]济南市长清区人民医院肛肠科,济南250300

出　　处：《中国当代医药》2014年第16期104-106,共3页China Modern Medicine

摘　　要：目的探讨不同剂量布比卡因蛛网膜下腔阻滞麻醉在肛周手术中的应用效果，以探讨最佳麻醉剂量。方法选择本院2012年4月～2013年12月蛛网膜下腔阻滞麻醉下行肛周手术的患者96例，随机分为3组，每组各32例，A组采用0．5％布比卡因2．0ml麻醉，B组采用0．5％布比卡因1．5ml麻醉，C组采用0．5％布比卡因1．0ml麻醉，观察3组患者的麻醉起效时间、麻醉效果、术后运动阻滞情况及并发症发生情况。结果3组患者的感觉阻滞起效时间、麻醉优良率比较，差异无统计学意义（P〉0．05），术毕时C组患者运动阻滞均为0～Ⅰ级（100．0％），A、B组下肢运动阻滞0～Ⅰ级者分别占12．5％、31．2％，明显低于C组，组间比较差异均有统计学意义（P〈0．05），且C组尿潴留发生率明显低于A、B组，差异有统计学意义（P〈0．05）。结论肛周手术中采用0．5％布比卡因1．0ml蛛网膜下腔阻滞麻醉，在保证麻醉效果的同时，能够有效减轻术后下肢运动神经阻滞，避免术后尿潴留，可作为肛周手术的最佳麻醉剂量。Objective To investigate effect of different doses of bupivacaine subarachnoid anesthesia in perianal surgery,and investigate the best anesthetic dose. Methods 96 patients who were given perianal surgery under subarachnoid anesthesia in our hospital from April 2012 to December 2013 were randomly divided into three groups,32 cases in each group,the dose of 0.5% bupivacaine in group A,group B group,C were 2.0,1.5,1.0 ml respectively,the onset time, anesthesia effect,postoperative motor block and complications of three groups were observed. Results The sensory block onset time and anesthesia excellent rate of three groups were compared,the difference was not significant （P〉0.05）,at the end of surgery,motor block level of group C were all in class 0-Ⅰ （100.0%）,and the patients with motor block level in 0-Ⅰ class in group A,group B accounted for 12.5%,31.2% respectively,significantly lower than group C,the differences were significant （P〈0.05）,the urinary retention rate in group C was significantly lower than that in group A,group B,the difference was significant （P〈0.05）. Conclusion In perianal surgery,subarachnoid anesthesia with 0.5% bupivacaine 1.0 ml can ensure anesthetic effect,at the same time can effectively reduce postoperative lower limb motor block, avoid postoperative urinary retention,can be suggested as the best anesthesia dose in perianal surgery.

关 键 词：布比卡因 肛周手术 蛛网膜下腔阻滞麻醉 运动阻滞 尿潴留 

分 类 号：R614.4[医药卫生—麻醉学]