羟考酮镇痛辅助腰俞穴麻醉在肛肠手术中的应用  

Application of Oxycodone Analgesia Assisted Yaoshu Point Anesthesia in Anorectal Surgery

作　　者：陈丽丽[1] 王大亮 张霞[2] 刁春丽 韩冰[3] 王玉寰 CHEN Lili;WANG Daliang;ZHANG Xia;DIAO Chunli;HAN Bing;WANG Yuhuan(Department of Anesthesiology,The People’s Hospital of Huaiyin,Ji’nan Shandong 250021,China;Second Department of Surgery,The People’s Hospital of Huaiyin,Ji’nan Shandong 250021,China;Medical Department,The People’s Hospital of Huaiyin,Ji’nan Shandong 250021,China;Hospital Infection Department,The People’s Hospital of Huaiyin,Ji’nan Shandong 250021,China)

机构地区：[1]山东省济南市槐荫人民医院手术麻醉科,山东济南250021 [2]山东省济南市槐荫人民医院外二科,山东济南250021 [3]山东省济南市槐荫人民医院医务科,山东济南250021 [4]山东省济南市槐荫人民医院院感科,山东济南250021

出　　处：《中国继续医学教育》2020年第23期117-120,共4页China Continuing Medical Education

摘　　要：目的评价肛肠手术中,静脉给予羟考酮镇痛以辅助腰俞穴麻醉的效果。方法选取2019年7月—2019年12月择期行肛肠手术的本院患者160例,并将其随机分为两组(其中每组80例)。辅助镇痛组(Q组)在给予腰俞穴麻醉后,再静脉给予羟考酮0.1 mg/kg;单次腰腧穴麻醉组(Y组)仅进行腰俞穴麻醉。两组患者的腰俞穴麻醉用药均为2%利多卡因(5 mL)+1%罗哌卡因(10 mL)+0.9%氯化钠注射液(5 mL),共计20 mL。记录患者麻醉前、术中牵拉时、术毕的生命体征变化,包括心率、血氧饱和度以及平均动脉压。并记录麻醉效果、术中牵拉反应、不良反应及并发症、术后疼痛评分。结果与Y组相比,Q组在稳定血流动力学、提高麻醉效果、减少术中牵拉反应、降低术后疼痛评分方面具有显著优势,差异有统计学意义(P<0.05)。结论腰俞穴麻醉联合羟考酮静脉镇痛可潜在提高肛肠手术患者的麻醉疗效及术后镇痛。Objective To explore the effect of oxycodone assisted Yaoshu anesthesia in anorectal operation.Methods There are 160 patients performing selective anorectal operation,which were divided into two groups randomly(80 patients in each group)from July 2019 to December 2019:Auxiliary analgesia group(Group Q)was given 0.1 mg/kg oxycodone by intravenous injection after Yaoshu point anesthesia.In only single Yaoshu anesthesia group(Group Y),only Yaoshu point anesthesia was performed.The drugs used for Yaoshu point anesthesia in two groups were 20 ml:2%lidocaine(5 mL)+1%ropivacaine(10 mL)+0.9%sodium chloride(5 mL).The patient’s vital signs at different time points were recorded,containing heart rate,blood oxygen saturation,as well as mean arterial pressure.Simultaneously we record the anesthesia effect,intraoperative traction reaction,adverse reactions,complications and postoperative pain score.Results Compared with group Y,group Q has significant advantages in stabilizing hemodynamics,improving anesthetic effect,reducing intraoperative traction response and postoperative pain score(P<0.05).Conclusion Oxycodone assisting Yaoshu anesthesia can improve anesthesia effect and reduce postoperative pain in patients undergoing anorectal surgery.

关 键 词：羟考酮 腰俞穴麻醉 肛肠疾病手术 牵拉反应 麻醉效果 视觉模拟评分 

分 类 号：R614[医药卫生—麻醉学]