低浓度罗哌卡因腰麻用于肛肠手术临床研究.docVIP

低浓度罗哌卡因腰麻用于肛肠手术的临床研究 　　[摘要] 目的 比较0.3%、0.25%，0.2%三种浓度罗哌卡因腰麻用于肛肠手术的临床效果。 方法 整群选取该院2014年12月―2015年6月收治的择期肛肠手术患者共60例，ASAⅠ～Ⅱ级，随机分为3组，每组20例。用25G腰穿针（针内针）行蛛网膜下腔穿刺，于L3～4刺入蛛网膜下腔，注入重比重局麻药3mL（A组0.3%罗哌卡因9 mg，B组 0.25%罗哌卡因7.5 mg，C组0.2%罗哌卡因6 mg）。观察记录3组的麻醉效果及不良反应情况。 结果 感觉运动起效时间3组差异无统计学意义（P0.05），感觉运动维持时间A组B组C组，3组相比差异均有统计学意义（P0.05）。B组与C组低血压的发生率少于A组，差异有统计学意义（P0.05）；而B组的牵拉反应少于C组，差异有统计学意义（P0.05）。结论 0.25%罗哌卡因是用于肛肠手术腰麻的合适浓度，循环稳定，不良反应少。 　　[关键词] 浓度；罗哌卡因；腰麻；肛肠手术；细针 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）11（c）-0125-04 　　[Abstract] Objective To compare the clinical effect of three concentration ropivacaine of 0.3%， 0.25%， 0.2% for spinal anesthesia in anorectal surgery. Methods 60 cases of patients prepared for anorectal surgery admitted in our hospital from December 2014 to June2015 and graded by American Anesthesia Association（ASA） in classⅠor class Ⅱwere randomly divided into three groups with 20 cases in each. 25G spinal needle for subarachnoid puncture and stabbed into the subarachnoid space at L3～4， with injection of 3ml hyperbaric local anesthetics（A group 0.3% ropivacaine 9mg；B group 0.25% ropivacaine 7.5mg； C group 0.2% ropivacaine 6mg）.The anesthetic effect and adverse reactions of the three groups were observed. Results There was no statistically significant difference in the onset time of sensory and motor between the three groups（P0.05）.The maintain time of sensory and motor： group Agroup B group C， the difference between the three groups was statistically significant（P0.05）.The incidence of hypotension in group B and group C was less than that of group A， the difference had statistical significance（P0.05），while group B had less draw reaction than group C， the difference had statistical significance（P0.05）. Conclusion 0.25% ropivacaine was suitable concentration for spinal anesthesia in anorectal operation with better cycle stability and less adverse reaction. 　　[Key words] Concentration； Ropivacaine； Spinal anesthesia； Anorectal operation； Fine needle 　　肛肠部手术相对短小，但要求肛门