罗哌卡因联合舒芬太尼蛛网膜下腔阻滞麻醉在PPH患者中的应用效果  

Application Effect of Ropivacaine Combined with Sufentanil Subarachnoid Block Anesthesia in Patients with PPH

作　　者：吴惠卿 邓媛 杨健发 WU Huiqing;DENG Yuan;YANG Jianfa(Department of Anesthesiology,Ruijin People's Hospital,Ruijin 342500,China)

机构地区：[1]瑞金市人民医院麻醉科,江西瑞金342500

出　　处：《中国医学创新》2025年第11期121-124,共4页Medical Innovation of China

摘　　要：目的:观察罗哌卡因联合舒芬太尼蛛网膜下腔阻滞麻醉用于吻合器痔上黏膜环切术(PPH)的效果。方法:选取2022年4月—2024年3月于瑞金市人民医院进行PPH的102例患者作为研究对象,按照随机数字表法分为P组和R组,各51例。P组进行罗哌卡因蛛网膜下腔阻滞,R组进行罗哌卡因联合舒芬太尼蛛网膜下腔阻滞。对比两组的肛门松弛优良率、内脏牵拉反应发生率、下肢运动神经阻滞程度(Bromage评分)、麻醉起效时间和镇痛维持时间;对比两组术后视觉模拟评分法(VAS)评分及不良反应发生率。结果:两组肛门松弛优良率、Bromage评分比较,差异均无统计学意义(P>0.05);R组内脏牵拉反应发生率低于P组,麻醉起效时间早于P组,镇痛维持时间长于P组,差异均有统计学意义(P<0.05)。R组术后VAS评分低于P组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:与单独使用罗哌卡因相比,罗哌卡因联合舒芬太尼蛛网膜下腔阻滞麻醉用于PPH患者中效果更好,内脏牵拉反应发生率更低,麻醉起效时间更早,镇痛维持时间更长,更能降低患者术后的疼痛程度,且安全性较好。Objective:To observe the effect of Ropivacaine combined with Sufentanil subarachnoid block anesthesia in procedure for prolapse and hemorrhoids(PPH).Method:A total of 102 patients who underwent PPH in Ruijin People's Hospital from April 2022 to March 2024 were selected as the study objects and divided into group P and group R according to random number table method,with 51 patients in each group.Subarachnoid block of Ropivacaine was performed in group P,and subarachnoid block of Ropivacaine combined with Sufentanil was performed in group R.The superior and good rate of anal relaxation,the incidence of visceral pull reaction,the degree of lower extremity motor nerve block(Bromage score),the onset time of anesthesia and the duration of analgesia were compared between the two groups.Postoperative visual analogue scale(VAS)scores and incidence of adverse reactions were compared between the two groups.Result:There were no significant differences in the excellent and good rate of anal relaxation and Bromage score between the two groups(P>0.05).The incidence of visceral pull reaction in group R was lower than that in group P,the onset time of anesthesia was earlier than that in group P,and the duration of analgesia was longer than that in group P,the differences were statistically significant(P<0.05).The VAS score of group R was lower than that of group P,the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with Ropivacaine alone,Ropivacaine combined with Sufentanil subarachnoid block anesthesia has better effects in PPH patients,with lower incidence of visceral pull reaction,earlier onset time of anesthesia,longer duration of analgesia,and can reduce the degree of postoperative pain,with better safety.

关 键 词：罗哌卡因 舒芬太尼 蛛网膜下腔阻滞 吻合器痔上黏膜环切术 

分 类 号：R614[医药卫生—麻醉学]