不同剂量罗哌卡因腰麻在肛周手术中应用效果的随机对照研究  

Randomized Controlled Study on Different doses of Ropivacaine Spinal Anesthesia in Anorectal Surgery

作　　者：骆僡 王文君 任颖[1] 刘洋 刘炜[1] LUO Hui;WANG Wenjun;REN Ying;LIU Yang;LIU Wei(Liangxiang Hospital,Fangshan District,Beijing,Beijing 102401,China)

机构地区：[1]北京市房山区良乡医院,北京102401

出　　处：《中国医药指南》2023年第20期99-101,共3页Guide of China Medicine

摘　　要：目的比较不同剂量罗哌卡因腰麻在肛周手术中的应用效果,为进一步优化临床麻醉方案提供依据。方法选择2022年6~10月北京市房山区良乡医院择期于等比重腰麻下行肛周手术患者80例,年龄18~65岁,男59例,女21例,采用随机数字表法分为两组(n=40):低剂量罗哌卡因腰麻组(L组,0.1%罗哌卡因5 mg)与常规剂量罗哌卡因腰麻组(C组,0.15%罗哌卡因7.5 mg)。于L_(2~3)间隙行蛛网膜下腔穿刺,腰麻针斜面向骶尾侧,L组注射等比重0.1%罗哌卡因5 mL,C组注射0.15%罗哌卡因5 mL。记录两组感觉阻滞起效时间、最高感觉阻滞平面、感觉阻滞消退时间、运动阻滞起效时间,术后首次步行时间、首次排尿时间,记录术毕时改良Bromage评分以及术后头疼、术后恶心呕吐等不良事件发生的发生情况。结果与C组相比,L组首次步行时间、感觉阻滞消退时间显著缩短,Bromage评分显著降低,差异有统计学意义(P<0.05)。结论低剂量罗哌卡因与常规剂量罗哌卡因相比,运动神经阻滞轻、恢复快,可满足肛周手术的需求。Objective The aim of this study is to compare the effects of two different doses of ropivacaine in anorectal surgery,and to provide evidence for further optimization of clinical anesthesia.Methods A total of 80 patients aged 18-65 years old,including 59 males and 21 females,undergoing anorectal surgery under spinal anesthesia were selected from Liangxiang Hospital of Fangshan District,Beijing from June to October 2022.They were divided into two groups by random number table method(n=40):low-dose ropivacaine group(group L,0.1%ropivacaine 5 mg)and conventional dose Ropivacaine group(Group C,0.15%ropivacaine 7.5 mg).A catheter was implanted into the subarachnoid space(L_(2-3) interspace)and advanced caudally untill umbar region.Group L received isobaric 0.1%ropivacaine 5 mL,and group C received isobaric 0.15%ropivacaine 5 mL.The onset time of sensory block,the highest sensory block plane,the time of sensory block resolution,the onset time of motor block,time to first ambulation,time to first urine voiding were recorded.The bromage score and the occurrence of postoperative headache,postoperative nausea and vomiting and other adverse events were recorded.Results Compared with group C,the time to first ambulation,and duration of sensory block in group L were significantly shorter,and the Bromage score was lower,with statistical significance(P<0.05).Conclusion Compared with conventional dose ropivacaine,low dose ropivacaine has less motor nerve block and faster recovery,which can meet the needs of perianal surgery.

关 键 词：脊髓 麻醉 肛周手术 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]