低位肛瘘手术应用小剂量2%利多卡因联合两点扇形麻醉法的可行性研究  

Feasibility study on small dose of 2% lidocaine combined with two-point sector anesthesia in the operation of low anal fistula

作　　者：牛文辉[1] 张少华[2] 李红艳[2] 张磊 赵莲英[4] 徐会志[2] NIU Wen-hui;ZHANG Shao-hua;LI Hong-yan;ZHANG Lei;ZHAO Lian-ying;XU Hui-zhi(Langfang People's Hospital,Langfang 065000,China;Hebei Province Geriatric Hospital,Shijiazhuang 050000,China;Sanhe Hospital,Langfang 065200,China;Affiliated Hospital of Hebei University of Engineering,Handan 056000,China)

机构地区：[1]廊坊市人民医院,河北廊坊065000 [2]河北省老年病医院,石家庄050000 [3]三河市医院,河北廊坊065200 [4]河北工程大学附属医院,河北邯郸056000

出　　处：《实用药物与临床》2019年第5期489-492,共4页Practical Pharmacy and Clinical Remedies

基　　金：河北省卫生和计划生育委员会2015年度医学科学研究课题计划项目(20150107)

摘　　要：目的探讨小剂量2%利多卡因骶管麻醉联合两点扇形麻醉法在低位肛瘘中的应用效果及安全性。方法随机选取2015年1-12月河北省老年病医院因肛肠疾病住院的120例患者作为研究对象,按照随机数字法分为观察组和对照组,每组60例。所有患者均采取手术治疗,其中观察组采用小剂量2%利多卡因骶管麻醉联合两点扇形麻醉法,对照组患者则采用鞍麻。观察两组患者麻醉阻滞前后血压及心率变化,记录并比较两组患者的感觉、运动阻滞维持时间、麻醉效果、术后疼痛程度及不良反应情况。结果两组患者麻醉阻滞后各时段的MAP、SpO_2及HR比较差异均无统计学意义(P>0.05);与观察组比较,对照组患者的感觉和运动阻滞时间均明显延长,术后肛门收缩恢复率及直肠牵拉反射率均处于较低水平(P<0.05)。观察组患者麻醉效果、术后VAS疼痛评分、术后轻度疼痛比例以及术后不良反应发生率等指标均明显优于对照组(P<0.05)。结论小剂量2%利多卡因骶管麻醉联合两点扇形麻醉可为临床手术提供较好的便利条件,患者应激反应以及术后疼痛轻,恢复时间短,安全性高。Objective To investigate the effect and safety of small dose of 2% lidocaine sacral anesthesia combined with two-point sector anesthesia in the treatment of low anal fistula.Methods Totally 120 hospitalized patients with anorectal diseases in Hebei Geriatric Hospital from January to December 2015 were randomly selected as the research subjects.They were divided into observation group and control group according to random number method,60 patients in each group.All patients were treated by surgery,and observation group was treated with small dose of 2% lidocaine sacral anesthesia combined with two-point sector anesthesia,while control group was treated with saddle anesthesia.The changes of blood pressure and heart rate before and after anesthesia were observed,and the sensation,duration of motor block,anesthetic effect,degree of pain and adverse reactions were recorded and compared between the two groups.Results There was no significant difference in MAP,SpO2 or HR between the two groups at different time intervals of anesthesia block(P>0.05).Compared with observation group,the time of sensory and motor block in control group was significantly prolonged,and the recovery rate of anal contraction and rectal traction reflex were at a lower level after operation(P<0.05).The anesthesia effect,VAS pain score,the proportion of mild pain and the incidence of adverse reactions in observation group were significantly better than those in control group(P<0.05).Conclusion Small dose of 2% lidocaine sacral anesthesia combined with two-point sector anesthesia can provide better convenience for clinical operation.Patients'stress response and postoperative pain are mild and the recovery time is short with good safety.

关 键 词：利多卡因 骶管麻醉 两点扇形麻醉 低位肛瘘 手术效果 

分 类 号：R614[医药卫生—麻醉学]