小剂量布比卡因鞍麻联合双氯芬酸钠栓剂术后镇痛在痔疮手术快速康复中的应用  

Application of low-dose bupivacaine saddle anesthesia combined with diclofenac sodium suppository for postoperative analgesia in the rapid rehabilitation of hemorrhoid surgery

作　　者：黄文 张敏 李坤 张琳 HUANG Wen;ZHANG Min;LI Kun;ZHANG Lin(Department of Anesthesiology,Xinyu People′s Hospital in Jiangxi Province,Xinyu 338000,China)

机构地区：[1]江西省新余市人民医院麻醉科,江西新余338000

出　　处：《中国现代医生》2022年第6期138-141,共4页China Modern Doctor

基　　金：江西省新余市科技计划项目(20193090813)。

摘　　要：目的探讨小剂量布比卡因鞍麻联合双氯芬酸钠栓剂术后镇痛在痔疮手术快速康复中的应用。方法选取2019年11月至2020年12月新余市人民医院行手术治疗的70例痔疮患者作为本研究对象。按照随机数字表对照法分为两组,每组35例。患者均实施混合痔外剥内扎术治疗。对照组接受小剂量布比卡因鞍麻,观察组在此基础上加用双氯芬酸钠栓剂镇痛。比较两组患者术中麻醉效果、术后改良Bromage评分、伤口痛觉恢复时间、首次排尿时间、住院时间以及并发症发生情况。结果两组患者术中痛觉完全阻滞率、肛门松弛率、牵拉反应率比较,差异无统计学意义(P>0.05);两组术后改良Bromage评分均为0分,患者可下地自行回到病房。观察组伤口痛觉恢复时间、首次排尿时间、住院时间均短于对照组,差异有统计学意义(P<0.05);观察组和对照组并发症总发生率比较,差异无统计学意义(P>0.05)。结论小剂量布比卡因鞍麻联合双氯芬酸钠栓剂术后镇痛效果显著,患者早期不影响患者早期下床活动,且恢复时间更短,并发症发生率较低,值得临床推荐。Objective To investigate the application of low-dose bupivacaine saddle anesthesia combined with diclofenac sodium suppository for postoperative analgesia in the rapid rehabilitation of hemorrhoid surgery.Methods A total of 70 patients with hemorrhoids who underwent surgical treatment in Xinyu People′s Hospital from November2019 to December 2020 were included as the study subjects.According to the random number table comparison method,they were divided into two groups with 35 cases in each group.All patients were treated with external excision and internal ligation of mixed hemorrhoids.The control group received low-dose bupivacaine saddle anesthesia,and the observation group received diclofenac sodium suppository for analgesia on the basis of the same anesthesia as the control group.The intraoperative anesthesia effect,postoperative modified Bromage scores,time to feel wound pain,time to first urination,length of hospital stay and complications were compared between the two groups.Results There were no statistically significant differences in terms of intraoperative pain complete block rate,anal relaxation rate and traction response rate of patients between the two groups(P>0.05).The postoperative modified Bromage scores of the two groups were all 0 points,and the patients could get out of the bed and return to the ward on their own.The time to feel wound pain,time to first urination and length of hospital stay in the observation group were shorter than those in the control group,with statistically significant differences between the data(P<0.05).There was no statistically significant difference in terms of total incidence of complications between the observation group and the control group(P>0.05).Conclusion The low-dose bupivacaine saddle anesthesia combined with diclofenac sodium suppository for postoperative analgesia shows a significant effect.Out-of-bed activities of patients are not affected in the early stage,with shorter recovery time and lower incidence of complications.It is worthy of clinical recom

关 键 词：小剂量布比卡因鞍麻 双氯芬酸钠栓剂 术后镇痛 痔疮手术 快速康复 

分 类 号：R657.4[医药卫生—外科学]