利多卡因联合罗哌卡因在高位马蹄形肛周脓肿手术中的应用  

Application of Lidocaine Combined with Ropivacaine in Operation of High Horseshoe-shaped Perianal Abscess

作　　者：吕明慧 郝萍 张琳 LV Ming-hui;HAO Ping;ZHANG Lin(Xinxiang Xinhua Hospital,Henan Xinxiang 453000)

机构地区：[1]新乡新华医院,河南新乡453000

出　　处：《深圳中西医结合杂志》2021年第24期125-128,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:研究利多卡因联合罗哌卡因B超引导下骶管阻滞在高位马蹄形肛周脓肿患者手术麻醉中的应用效果。方法:选取新乡新华医院2019年11月至2020年12月收治的高位马蹄形肛周脓肿患者62例,均行切开双挂线引流术治疗,依据麻醉引导方式不同分为传统组(31例)、超声组(31例),传统组予以解剖定位进行骶管阻滞麻醉,超声组予以B超引导下进行骶管阻滞麻醉,统计比较两组患者的穿刺时间、麻醉起效时间、痛觉消退时间、调整穿刺针次数、麻醉效果、不良事件发生情况以及术后即刻(T1)、术后30 min(T2)、术后1 h(T3)、术后2 h(T4)、术后4 h(T5)、术后8 h(T6)、术后24 h(T7)疼痛程度〔视觉模拟评分法(VAS)〕。结果:超声组麻醉起效时间、痛觉消退时间短于传统组,调整穿刺针次数少于传统组,穿刺时间长于传统组,差异均具有统计学意义(P<0.05);超声组麻醉效果优于传统组,差异具有统计学意义(P<0.05);超声组局麻药中毒发生率、出血发生率、血肿发生率均低于传统组,差异具有统计学意义(P<0.05);超声组恶心发生率、尿潴留发生率、呕吐发生率与传统组比较,差异无统计学意义(P>0.05);超声组患者T2、T3、T4时VAS评分低于传统组,差异具有统计学意义(P<0.05)。结论:利多卡因联合罗哌卡因B超引导下骶管阻滞应用于高位马蹄形肛周脓肿患者手术麻醉中可改善麻醉效果、穿刺效果,缓解术后疼痛,降低不良事件发生率。Objective To study the effect of lidocaine combined with ropivacaine B-ultrasound-guided sacral canal block in surgical anesthesia for patients with high horseshoe-shaped perianal abscess.Methods A total of 62 patients with high horseshoe-shaped perianal abscess admitted to Xinxiang Xinhua Hospital from November 2019 to December 2020 were selected.All of them were treated with incision and double hanging wire drainage.According to different anesthesia guidance methods,they were divided into traditional group and ultrasound group with 31 cases in each group.The traditional group was anatomically positioned for sacral block anesthesia,and the ultrasound group was performed sacral block anesthesia under the guidance of B ultrasound.The two groups were statistically compared in terms of puncture time,anesthetic onset time,analgesic regression time,adjustment of puncture needle number,anesthetic effect,adverse events,as well as immediate postoperative(T1),postoperative 30 min(T2),postoperative 1h(T3),postoperative 2h(T4),postoperative 4h(T5),postoperative 8h(T6),postoperative 24h(T7)degree of pain[visual analogue scale(VAS)].Results The ultrasound group had shorter anesthesia onset time and pain resolution time compared with the traditional group,adjusted the number of puncture needles in the ultrasoud group was less than that in the traditional group,and the puncture time was longer than the traditional group.The differences were statistically significant(P<0.05);The anesthesia effect of the ultrasound group was better than that of the traditional group,and the difference was statistically significant(P<0.05);The incidence of local anesthetic poisoning,bleeding,and hematoma in the ultrasound group were lower than those in the traditional group,and the differences were statistically significant(P<0.05);There was no significant difference in the incidence of nausea,urinary retention,and vomiting between the ultrasound group and the traditional group(P>0.05).Conclusion The application of lidocaine combined with ropivaca

关 键 词：高位马蹄形肛周脓肿 利多卡因 罗哌卡因 骶管阻滞麻醉 

分 类 号：R614[医药卫生—麻醉学]