小剂量布比卡因复合舒芬太尼蛛网膜下腔麻醉在吻合器痔上黏膜环切术中的应用

发布时间：2018-03-15 06:28

本文选题：布比卡因　切入点：舒芬太尼　出处：《山东大学学报(医学版)》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨小剂量布比卡因复合舒芬太尼蛛网膜下腔注射在吻合器痔上黏膜环切术(PPH)中应用的可行性。方法择期行PPH的患者60例,随机分为布比卡因复合舒芬太尼组(BS组,n=30)和布比卡因组(B组,n=30)。BS组蛛网膜下腔注射布比卡因6 mg复合舒芬太尼2μg的混合液0.9 mL,即0.75%布比卡因0.8 mL+0.002%舒芬太尼0.1 mL;B组蛛网膜下腔注射布比卡因10 mg,即0.5%布比卡因2 mL。以VAS评分评价术中用吻合器行痔上黏膜环切时的患者不适感,以改良Bromage法评分评价术毕即刻双下肢运动神经阻滞情况,观察麻醉平面、手术医师满意度及术后排尿情况。结果与B组相比,BS组VAS及改良Bromage法评分降低(P0.001),麻醉平面降低(P0.001),手术医师满意度升高(P=0.002)。两组患者术后排尿情况差异无统计学意义(P=0.250)。结论应用PPH行蛛网膜下腔注射小剂量布比卡因复合舒芬太尼的麻醉效果优于单纯应用布比卡因。
[Abstract]:Objective to investigate the feasibility of low dose bupivacaine combined with sufentanil subarachnoid injection in prolapse and hemorrhoidectomy. They were randomly divided into bupivacaine combined with sufentanil group (group B) and bupivacaine group (group B) and bupivacaine group (group B). Subarachnoid injection of bupivacaine 6 mg combined with sufentanil (2 渭 g) was 0.9 mL, that is, 0.75% bupivacaine 0.8 mL and 0.002% sufentanil 0.1 mL. Subarachnoid injection of bupivacaine (10 mg, 0.5% bupivacaine 2 mL) was used to evaluate the discomfort of patients undergoing hemorrhoidectomy with stapler. The motor nerve block of both lower extremities was evaluated by the modified Bromage method and the anesthetic level was observed. Results compared with group B, the scores of VAS and modified Bromage in BS group were significantly lower than those in group B (P 0.001), anesthesia level was decreased (P 0.001), and the degree of satisfaction was increased. There was no significant difference between the two groups in postoperative urination. Conclusion low dose bupivacaine combined with sufentanil by subarachnoid injection is more effective than bupivacaine alone.
【作者单位】：东营市人民医院麻醉科;中国医学科学院北京协和医院麻醉科;
【分类号】：R614

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