小剂量罗哌卡因蛛网膜下腔注射用于混合痔手术的麻醉效果及对血流动力学指标及术后康复的影响  

Anesthetic effects of low-dose ropivacaine subarachnoid injection in mixed hemorrhoids surgery and its influence on hemodynamics and postoperative rehabilitation

作　　者：李思海 田志红 周素雅 Li Sihai;Tian Zhihong;Zhou Suya(Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第三附属医院,郑州450000

出　　处：《中国实用医刊》2023年第13期60-63,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨小剂量罗哌卡因蛛网膜下腔注射用于混合痔手术的麻醉效果及对血流动力学指标及术后康复的影响。方法抽取2020年6月至2022年6月河南中医药大学第三附属医院收治的混合痔患者96例,按随机数字表法分为对照组与观察组,每组48例。两组患者均接受吻合器痔状黏膜环切术配合外痔切除术治疗,对照组予以布比卡因蛛网膜下腔注射麻醉处理,观察组予以小剂量罗哌卡因蛛网膜下腔注射麻醉处理。对比两组麻醉效果及血流动力学、术后康复情况,并开展安全性评估。结果两组感觉阻滞起效时间、运动阻滞起效时间、感觉阻滞持续时间比较,差异未见统计学意义(P>0.05);观察组运动阻滞持续时间[(205.72±28.13)min]低于对照组[(239.57±35.41)min],(P<0.05)。术后2 h,两组心率、收缩压及舒张压均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。观察组术后首次排气时间及下床活动时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。两组围术期不良反应发生率比较差异未见统计学意义(P>0.05)。结论混合痔手术中予以患者小剂量罗哌卡因蛛网膜下腔注射可取得更好的麻醉效果,可避免机体血流动力学过度波动,且利于术后康复,安全性高。ObjectiveTo investigate the anesthetic effects of low-dose ropivacaine subarachnoid injection in mixed hemorrhoids surgery,and its influence on hemodynamics and postoperative rehabilitation.MethodsNinety-six patients with mixed hemorrhoids treated in Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from June 2020 to June 2022 were selected,and they were divided into control group and observation group according to the random number table method,with 48 cases in each group.Patients in both groups were treated by stapler hemorrhoidal mucosal loop resection combined with external hemorrhoidectomy;the control group was given subarachnoid anesthesia with bupivacaine injection,and the observation group was given subarachnoid anesthesia with low-dose ropivacaine injection.The anaesthetic effect,haemodynamics,postoperative recovery were compared between the two groups,and safety assessments was performed.ResultsThere was no significant difference in the onset time of sensory block,onset time of motor block,or duration of sensory block between the two groups(P>0.05).The duration of motor block in the observation group was(205.72±28.13)min shorter than the(239.57±35.41)min in the control group(P<0.05).Compared with these indexes before surgery,heart rate,systolic blood pressure,and diastolic blood pressure increased in both groups 2 hours after surgery,however,the observation group had lower heart rate,systolic blood pressure,and diastolic blood pressure,compared with the control group(P<0.05).The time of first flatus,first time of out-of-bed activity,and duration of hospital stay in the observation group were shorter than those in the control group(P<0.05).There was no significant difference in the incidence of perioperative adverse reactions between the two groups(P>0.05).ConclusionsThe subarachnoid injection of low-dose ropivacaine in mixed hemorrhoids surgery achieves better anesthesia results,which can avoid excessive fluctuation of body hemodynamics,and is beneficial to postoperative re

关 键 词：痔疮 罗哌卡因 麻醉效果 血流动力学 术后康复 

分 类 号：R614[医药卫生—麻醉学]