肛肠外科手术不同麻醉的效果与并发症相关分析  

Analysis of anesthesia efficacy of different anesthesia regimens in anorectal surgery and its correlation with postoperative complications

作　　者：吴美华 赵建勇 郑君丽 WU Meihua;ZHAO Jianyong;ZHENG Junli(Zhejiang Chinese Medical University,Zhejiang 311000,China)

机构地区：[1]浙江中医药大学,杭州311100 [2]浙江省杭州市临平区第一人民医院

出　　处：《浙江创伤外科》2023年第4期635-638,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探究不同麻醉方案在肛肠外科手术患者中应用效果,并分析麻醉效果与发生术后并发症相关性。方法回顾性分析2021年5月至2022年5月到浙江省杭州市临平区第一人民医院行肛肠外科手术的150例患者的临床资料,根据所采用的不同麻醉方案分为对照组(n=75)及观察组(n=75)。对照组采用2.5 mL 0.25%罗哌卡因腰麻,观察组采用2.5 mL 0.6%罗哌卡因腰麻。观察两组患者术后疼痛、血流动力学、麻醉效果及术后并发症发生情况,并采用Spearman法对麻醉效果与是否发生术后并发症进行相关性分析。结果两组患者在术后6 h、术后12 h及术后24 h时,观察组NRS评分均低于对照组,并且两组患者NRS评分均随时间发展而呈逐渐降低趋势(P<0.05);麻醉后,两组患者心率、收缩压、舒张压及SaO2水平均较麻醉前低,并且观察组各指标水平均低于对照组(P<0.05);观察组麻醉起效时间低于对照组,伤口疼痛恢复时间及感觉阻滞时间高于对照组(P<0.05);两组患者术后并发症发生率相比无明显差异(P>0.05);麻醉起效时间与发生术后并发症呈正相关(r=-0.321,P<0.05),伤口疼痛恢复时间与感觉阻滞时间与发生术后并发症呈负相关(r=-0.311,-0.333,P<0.05)。结论在肛肠外科手术中采用高浓度罗哌卡因麻醉安全性较好,且感觉阻滞时间较长,利于提高术后镇痛效果。Objective To explore the effects of different anesthesia regimens in patients undergoing anorectal surgery,and to analyze the correlation between anesthesia efficacy and postoperative complications.Methods 150 patients who underwent anorectal surgery in our hospital from May 2021 to May 2022 were retrospective analyzed.They were divided into control group(n=75)and observation group(n=75)according to different anesthesia regimens used.The control group used 2.5 mL of 0.25%ropivacaine lumbar anesthesia,and the observation group used 2.5 mL of 0.6%ropivacaine lumbar anesthesia.The postoperative pain,hemodynamics,anesthesia effect and postoperative complications of the two groups were observed,and the Spearman method was used to analyze the correlation between the anesthesia effect and the occurrence of postoperative complications.Results At 6h postoperative,12h postoperative and 24h postoperative,the NRS scores of the observation group were lower than those in the control group,and the NRS scores of both groups decreased gradually with time(P<0.05).After anesthesia,the levels of heart rate,systolic blood pressure,diastolic blood pressure and SaO2 in both groups were lower than those before anesthesia,and the levels of all indexes in the observation group were lower than those in the control group(P<0.05).The onset time of anesthesia in the observation group was lower than that of the control group,and the recovery time of wound pain and sensory block time were higher than those of the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).The onset of anesthesia was positively correlated with postoperative complications(r=-0.321,P<0.05),and the recovery time of wound pain and sensory block were inversely correlated with postoperative complications(r=-0.311,-0.333,P<0.05).Conclusion The use of high-concentration ropivacaine anesthesia in anorectal surgery has a good safety profile and a longer sensory blockade time,which is conducive to

关 键 词：麻醉方案 肛肠外科手术 麻醉效果 术后并发症 相关性 

分 类 号：R614.4[医药卫生—麻醉学]