大隐静脉高位结扎抽剥术麻醉中布比卡因的用量与安全性分析  

Dosage and safety analysis of bupivacaine during anesthesia for GSV high ligation and stripping

作　　者：王运 丁锐[2] Wang Yun;Ding Rui(Department of Anesthesiology,West District,Hefei First People's Hospital,Hefei 230031,Anhui,China;Department of Vascular Surgery,Hefei First People's Hospital,Hefei 230031,Anhui,China)

机构地区：[1]合肥市第一人民医院西区麻醉科,安徽合肥230031 [2]合肥市第一人民医院血管外科,安徽合肥230031

出　　处：《血管与腔内血管外科杂志》2021年第11期1363-1367,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨大隐静脉(GSV)高位结扎抽剥术麻醉中布比卡因的用量与安全性。方法收集2018年1月至2021年10月于合肥市第一人民医院西区行GSV高位结扎抽剥术患者的临床资料,采用倾向匹配法按照1∶1的比例选取4 mg布比卡因腰硬联合麻醉患者(4 mg组)与7 mg布比卡因腰硬联合麻醉患者(7 mg组),各30例。比较两组患者的围手术期指标(手术时间、术中输液量、术后排尿恢复时间、术后24 h疼痛程度),麻醉情况指标(术中2%利多卡因追加量、Ramsay评分、起效时间、最高痛觉阻滞平面),术前与术中生命体征指标[收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO_(2))],术前、术后1 d炎性因子指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平],以及术后麻醉相关不良反应发生情况。结果两组患者的手术时间、术中输液量、术后24 h视觉模拟评分法(VAS)评分比较,差异均无统计学意义(P>0.05);4 mg组患者的术后排尿恢复时间明显短于7 mg组患者(P<0.01)。两组患者术中均未追加2%利多卡因。4 mg组患者的最高痛觉阻滞平面低于7 mg组患者(P<0.05)。4 mg组患者的术中SpO_(2)明显高于7 mg组患者(P<0.01)。4 mg组患者术后尿潴留的发生率低于7 mg组患者(P=0.008);两组患者术后恶心、呕吐的发生率比较,差异均无统计学意义(P>0.05)。结论GSV高位结扎抽剥术采用4 mg布比卡因腰硬联合麻醉与7 mg布比卡因腰硬联合麻醉的效果相当,但安全性更高,可降低患者术后尿潴留的发生风险。Objective To investigate the dosage and safety of bupivacaine during anesthesia for the great saphenous vein(GSV)high ligation and stripping.Method The clinical data of patients who underwent GSV high ligation and stripping in West District,Hefei First People's Hospital from January 2018 to October 2021 were collected.Propensity matching method was used to select 4 mg bupivacaine and combined spinal-epidural(CSE)anesthesia patients and 7 mg bupivacaine combined with CSE patients with 30 cases each according to the ratio of 1∶1.The perioperative indicators(operation time,intraoperative infusion volume,postoperative urination recovery time,and postoperative 24 h pain degree),anesthesia indicators(intraoperative 2%lidocaine additional dose,Ramsay score,starting time,and the highest pain block level),preoperative and intraoperative vital signs[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),blood oxygen saturation(SpO_(2))],preoperative and postoperative 1-day inflammatory factor indicators[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels],and postoperative anesthesia-related adverse events were compared between the two groups of patients.Result There was no significant difference in the operation time,intraoperative infusion volume,and 24h visual analogue scale(VAS)score after the operation between the two groups(P>0.05);the postoperative urination recovery time of the 4 mg group was significantly shorter than that of the 7 mg group(P<0.01).No additional 2%lidocaine was given during the operation in both groups.The highest pain block level in the 4 mg group was lower than that in the 7 mg group(P<0.05).The intraoperative SpO_(2) of the 4 mg group was significantly higher than that of the 7 mg group(P<0.01).The incidence of postoperative urinary retention in the 4 mg group was lower than that in the 7 mg group(P=0.008);there was no significant difference in the incidence of postoperative nausea and vomiting between the two groups(P>0.05).Conclusion The eff

关 键 词：大隐静脉 高位结扎术抽剥术 腰硬联合麻醉 布比卡因 安全性 

分 类 号：R543[医药卫生—心血管疾病]