氯普鲁卡因复合芬太尼硬膜外麻醉在日间肛肠手术中的临床应用  

Clinical application of epidural Chloroprocaine combined with Fentanyl to patients undergoing daytime anorectal surgery

作　　者：杨树忠[1] 陈福华[1] 张富[2] 王智慧[1] 王振芹 张山[3] 

机构地区：[1]玉田县医院麻醉科,河北石家庄050000 [2]玉田县医院普外科,河北石家庄050000 [3]河北医科大学第二医院麻醉科,河北石家庄050000

出　　处：《临床军医杂志》2014年第10期1033-1036,共4页Clinical Journal of Medical Officers

基　　金：河北省唐山市科技局科学技术研究与发展指导计划课题(编号:131302107a)

摘　　要：目的比较氯普鲁卡因复合芬太尼与利多卡因复合芬太尼在日间肛肠手术中硬膜外麻醉的效果。方法将110例日间肛肠手术患者,按随机数字表法分为两组,每组各55例。对照组:使用2%利多卡因复合芬太尼;试验组:使用3%氯普鲁卡因复合芬太尼。两组均采用硬膜外麻醉的方式。观察两组患者麻醉的起效时间、痛觉消失时间、运动阻滞时间、运动阻滞持续时间、肌松程度、术后30 min视觉模拟评分(Visual analogue scale,VAS)、麻醉前后呼吸循环指标变化情况、手术时间、出院时间以及不良反应发生率等。结果试验组的麻醉起效时间、痛觉消失时间、运动阻滞时间、运动阻滞持续时间和出院时间均比对照组短(P<0.05),而两组患者术后30 min VAS评分、肌松程度、手术时间、麻醉前后呼吸循环指标变化情况以及不良反应发生率逐项比较,差异均无统计学意义(P>0.05)。结论氯普鲁卡因复合芬太尼与利多卡因复合芬太尼用于日间肛肠手术的硬膜外麻醉效果相似,但氯普鲁卡因复合芬太尼组起效快,下肢运动功能恢复早,住院时间短。Objective To compare the clinical efficiency of Chloroprocaine versus lidocaine combined with Fentanyl for epidural anesthesia in patients undergoing daytime anorectal surgery. Methods A total of 110 patients undergoing daytime anorectal surgery were randomly divided into two groups （n = 55/group）. Trial group received epidural anesthesia with Chloroprocaine combined with Fentanyl, however, control group received epidural anesthesia with lidocaine combined with Fentanyl. The parameters, such as on- set time of anesthesia, onset time of pain sensation block and motor block, duration of motor block, degree of muscle relaxation, visual analogue scale （VAS） scores at 30 min after surgery, changes in respiratory and circulatory indexes, operation time, discharge time and incidence rate of adverse reactions, were observed and recorded. Results Compared with the control group, the onset time of anesthesia, the disappearing time of pain sensation, the onset time of motor block, the duration of motor block and the discharge time were shorter or earlier in the trial group （ P 〈 0.05 ）. There were no statistical differences in the other indicators between the two groups （ P 〉 0. 05 ）. Conclusion Chloroproeaine for epidural anesthesia in daytime anoreetal surgery is of similar efficiency with lidocaine when combined with Fentanyl, however, the former has the advantage of earlier onset time, earlier recovery of motor blockade and earlier discharge time.

关 键 词：氯普鲁卡因 芬太尼 硬膜外麻醉 肛肠手术 

分 类 号：R614.42[医药卫生—麻醉学]