骶管阻滞麻醉和蛛网膜下腔阻滞麻醉下肛肠手术者术后疼痛的对比分析  

Comparative Analysis of Postoperative Pain in Patients Undergoing Anorectal Surgery with Caudal Block Anesthesia and Subarachnoid Block Anesthesia

作　　者：曾燕 李霞[1] 胡强夫[1] ZENG Yan;LI Xia;HU Qiang-fu(Department of Anesthesiology,Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan450052)

机构地区：[1]郑州大学第五附属医院麻醉科,河南郑州450052

出　　处：《中国肛肠病杂志》2025年第2期56-58,共3页Chinese Journal of Coloproctology

摘　　要：目的:比较骶管阻滞麻醉和蛛网膜下腔阻滞麻醉下肛肠手术者术后疼痛情况。方法:选取2022年3月至2024年2月拟于我科行肛肠手术的80例患者,按照1∶1随机分配至观察组和对照组,各40例。观察组骶管阻滞麻醉下手术,对照组蛛网膜下腔阻滞麻醉下手术。比较2组患者术后疼痛情况、不良反应及睡眠障碍发生情况。结果:观察组术后急性锐痛发生率低于对照组,术后第3天静息、换药、下地、排便时VAS评分均低于对照组,P<0.05。2组术后急性灼烧样痛、坠胀痛发生率,以及术后1个月、3个月、6个月慢性疼痛发生率比较差异均无统计学意义,P>0.05。观察组恶心、呕吐、睡眠障碍发生率明显低于对照组,P<0.05。结论:骶管阻滞麻醉下肛肠手术后近期疼痛控制效果优于蛛网膜下腔阻滞麻醉,且不良反应、睡眠障碍发生率更低。Objective To compare the postoperative pain in patients undergoing anorectal surgery with caudal block anesthesia and subarachnoid block anesthesia.MethodsTotal 80 patients who underwent laparoscopic radical resection of colorectal cancer in our department from March 2022 to February 2024 were randomly assigned to the observation group and the control group at a ratio of 1:1,with 40 cases in each group.The observation group was operated with caudal block anesthesia,and the control group was operated with subarachnoid block anesthesia.The incidence rates of postoperative pain,adverse reactions and sleep disorders were compared between the two groups.Results The incidence of acute sharp pain after surgery in the observation group was lower than that in the control group,and the VAS scores at rest,dressing change,walking and defecation on the third day after surgery were lower than those in the control group(P<0.05).There were no significant differences in the incidence rates of acute burning pain,swelling pain,and chronic pain l,3,and 6 months after surgery between the two groups(P>O.05).The incidence rates of nausea,vomiting and sleep disorders in the observation group were significantly lower than those in the control group(P<o.05).Conclusion Caudal block anesthesia is superior to subarachnoid block anesthesia in short-term pain control after anorectal surgery,and the incidence rates of adverse reactions and sleep disorders are lower.

关 键 词：肛肠手术 骶管阻滞麻醉 蛛网膜下腔阻滞麻醉 术后疼痛 

分 类 号：R614[医药卫生—麻醉学]