不同剂量布比卡因蛛网膜下腔阻滞麻醉在肛周手术中效果评价.docVIP

不同剂量布比卡因蛛网膜下腔阻滞麻醉在肛周手术中效果评价 　　[摘要] 目的 探讨不同剂量布比卡因蛛网膜下腔阻滞麻醉在肛周手术中的应用效果，以探讨最佳麻醉剂量。 方法 选择本院2012年4月～2013年12月蛛网膜下腔阻滞麻醉下行肛周手术的患者96例，随机分为3组，每组各32例，A组采用0.5%布比卡因2.0 ml麻醉，B组采用0.5%布比卡因1.5 ml麻醉，C组采用0.5%布比卡因1.0 ml麻醉，观察3组患者的麻醉起效时间、麻醉效果、术后运动阻滞情况及并发症发生情况。 结果 3组患者的感觉阻滞起效时间、麻醉优良率比较，差异无统计学意义（P0.05），术毕时C组患者运动阻滞均为0～Ⅰ级（100.0%），A、B组下肢运动阻滞0～Ⅰ级者分别占12.5%、31.2%，明显低于C组，组间比较差异均有统计学意义（P　　[关键词] 布比卡因；肛周手术；蛛网膜下腔阻滞麻醉；运动阻滞；尿潴留 　　[中图分类号] R614.4[文献标识码] A[文章编号] 1674-4721（2014）06（a）-0104-03 　　 　　Effect evaluation of different doses of bupivacaine subarachnoid anesthesia in perianal surgery 　　DU Yu-heng1 HU Ming-yu2 　　1.Department of Anesthesiology,People′s Hospital of Changqing District in Jinan City,Jinan 250300，China;2.Anorectal Department,People′s Hospital of Changqing District in Jinan City,Jinan 250300,China 　　[Abstract] Objective To investigate effect of different doses of bupivacaine subarachnoid anesthesia in perianal surgery,and investigate the best anesthetic dose. Methods 96 patients who were given perianal surgery under subarachnoid anesthesia in our hospital from April 2012 to December 2013 were randomly divided into three groups,32 cases in each group,the dose of 0.5% bupivacaine in group A,group B group,C were 2.0,1.5,1.0 ml respectively,the onset time,anesthesia effect,postoperative motor block and complications of three groups were observed. Results The sensory block onset time and anesthesia excellent rate of three groups were compared,the difference was not significant (P0.05),at the end of surgery,motor block level of group C were all in class 0-I (100.0%),and the patients with motor block level in 0-I class in group A,group B accounted for 12.5%,31.2% respectively,significantly lower than group C,the differences were significant (P0.05），具有可比性。 　　1.2 方法 　　全部患者麻醉前30 min肌内注射苯巴比妥钠0.1 g，入室后监测血压、心率、血氧饱和度等，开放外周静脉，患者取坐位，采用7号腰椎穿刺针，在第4、5腰椎间隙进针行腰椎穿刺，穿刺成功后针头斜面向尾部，注入蛛网膜下腔阻滞麻醉药物；0.5%布比卡因麻醉前由0.75%布比卡因2 ml+10%葡萄糖溶液配制而成，A组注入0.5%布比卡因2.0 ml，B组注入0.5%布比卡因1.5 ml，C组注入0.5%布比卡因1.0 ml，麻醉药物注入速度为0.05 ml/s。麻醉