小剂量等比重布比卡因蛛网膜下腔麻醉在日间肛肠手术中的应用  

Application of low dose of bupivacaine in isobasic spinal anesthesia for day-surgery of anorectal patients

作　　者：李国艳[1] 周维品 李佳[1] 

机构地区：[1]成都市中西医结合医院麻醉科,四川成都610041 [2]成都市双流县中医院,四川成都610212

出　　处：《实用医院临床杂志》2014年第4期118-120,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨小剂量等比重布比卡因蛛网膜下腔麻醉在肛肠手术中的应用。方法 ASAⅠ～Ⅱ级的肛肠手术患者60例,蛛网膜下腔穿刺成功后按注入布比卡因不同剂量分为布比卡因等比重2.5 mg组（A组）和5 mg组（B组）,硬膜外置管。记录两组患者围术期血流动力学变化,感觉阻滞起效时间、感觉阻滞持续时间、运动阻滞持续时间、术后并发症。结果两组患者围术期血流动力学变化差异无统计学意义（P〉0.05）;A组感觉阻滞持续时间、运动阻滞持续时间短于B组（P〈0.01）,术后尿潴留发生率低于B组（P〈0.05）。结论 2.5 mg及5 mg等比重布比卡因均能满足肛肠手术麻醉需要,2.5 mg等比重布比卡因术后感觉、运动恢复更快,更有利患者及早离院。Objective To observe the clinic effect of isobasic spinal anesthesia with low dose of bupivacaine for day-surgery of anorectal patients.Methods Sixty ASA grade Ⅰ ～ Ⅱ patients underwent selective anorectal operation were randomly divided into2.5mg bupicaine group（group A） and 5mg bupicaine group（group B）.The bupicaine was mixed with cerebrospinal fluid after successful subarachnoid puncture and injected into the patients＇ subarachnoid cavity.Vital signs,onset time of sensation block,time to sensory recovery and movement recovery and adverse reaction were observed.Results No statistical differences in hemodynamics changes were found between the two groups.The sense block maintenance time and the movement recovery time in the group A was shorter than that in the group B（P 〈 0.01）.Conclusion Although both 2.5mg and 5mg bupicaine can obtain satisfactory clinical outcome for patients undergoing anorectal surgery,2.5mg bupicaine in isobaric spinal anesthesia can provide a shorter sensory recovery,movement recovery time and less rate of urinary retention.

关 键 词：布比卡因 等比重 蛛网膜下腔阻滞 肛门直肠手术 

分 类 号：R614.4[医药卫生—麻醉学]