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山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (3): 117-120.doi: 10.6040/j.issn.1671-7554.0.2016.245

• 临床医学 • 上一篇    下一篇

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

卜会敏1,田晓鹏1,刘金山1,谭刚2   

  1. 1. 东营市人民医院麻醉科, 山东 东营 257091;2.中国医学科学院北京协和医院麻醉科, 北京 100730
  • 收稿日期:2016-03-07 出版日期:2017-03-10 发布日期:2017-03-10
  • 通讯作者: 谭刚. E-mail:tangang@pumch.cn E-mail:tangang@pumch.cn

Effect of intrathecal injection of low-dose bupivacaine coadministered with sufentanil in procedure for prolapse and hemorrhoids

BU Huimin1, TIAN Xiaopeng1, LIU Jinshan1, TAN Gang2   

  1. 1. Department of Anesthesiology, Dongying Peoples Hospital, Dongying 257091, Shandong, China;
    2. Department of Anesthesiology, PUMC Hospital, CAMS&
    PUMC, Beijing 100730, China
  • Received:2016-03-07 Online:2017-03-10 Published:2017-03-10

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2 μg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(P<0.001),麻醉平面降低(P<0.001),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。

关键词: 吻合器痔上黏膜环切术, 舒芬太尼, 蛛网膜下腔阻滞麻醉, 布比卡因

Abstract: Objective To evaluate the anesthetic effect of intrathecal injection of low dose bupivacaine with sufentanil during procedure for prolapse and hemorrhoids(PPH). Methods Sixty patients who underwent selective operation of PPH were randomly divided into Group BS and Group B, with thirty in each group. Group BS received intrathecal injection of bupivacaine(6 mg)and sufentanil(2 μg), namely, 0.75% bupivacaine(0.8 mL)and 0.002% sufentanil(0.1 mL). Group B received intrathecal injection of bupivacaine(10 mg)only, namely, 0.5% bupivacaine(2 mL). Patients discomfort when using anastomosis instruments on hemorrhoids mucosa was evaluated by VAS score. The degree of motor nerve block of lower extremities immediately after surgery was evaluated by revised Bromage score. The level of anesthesia and the performer satisfaction were evaluated. Postoperative micturition situations were recorded. Results Compared with Group B, the VAS and immediate postoperative revised Bromage scores were significantly decreased(P<0.001), the level of anesthesia were lower(P<0.001), and the performer satisfaction were risen(P=0.002)in Group BS. There was no significant difference in the postoperative micturition condition between the two groups(P=0.250). Conclusion Intrathecal injection of low dose bupivacaine with sufentanil is superior to bupivacaine alone for PPH.

Key words: Bupivacaine, Procedure for prolapse and hemorrhoids, Spinal anesthesia, Sufentanil

中图分类号: 

  • R614.4
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