山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (4): 72-76.doi: 10.6040/j.issn.1671-7554.0.2018.1160
• • 上一篇
黄玉婷1,刘慧颖1,郑俊奕2
HUANG Yuting1, LIU Huiying1, ZHENG Junyi2
摘要： 目的 观察罗哌卡因蛛网膜下腔阻滞用于肛肠日间手术的最低有效浓度,探讨其在肛肠日间手术中的合理用药浓度和安全性。 方法 30例在日间行肛肠手术的患者,根据序贯方法,以上一例患者的麻醉效果,确定下一患者所用的罗哌卡因浓度,初始罗哌卡因浓度为0.50%,间隔浓度为0.05%,麻醉诱导后观察阻滞起效时间、阻滞完善时间、改良Bromage评分、VAS评分;术后随访观察麻醉镇痛时间、术后运动功能恢复时间、术后排尿功能恢复时间、不良反应及患者满意度。 结果 罗哌卡因用于肛肠日间手术的最低有效浓度为0.35%,剂量为7 mg,EC50为0.366%(95% CI:0.255%~0.423%),阻滞起效时间、阻滞完善时间、改良Bromage评分、VAS评分、麻醉镇痛时间、术后运动功能恢复时间与麻醉浓度差异有统计学意义(P<0.05)。药物浓度越高,阻滞起效时间、阻滞完善时间越短;药物浓度越低,麻醉镇痛时间越短,术后运动功能恢复越快,麻醉浓度与术后排尿功能恢复时间差异无统计学意义(P>0.05)。 结论 罗哌卡因用于肛肠日间手术的最低有效浓度为0.35%,剂量为7 mg,合适浓度罗哌卡因不仅能满足肛肠日间手术需求,也利于术后早期康复,为患者早日下床功能锻炼提供可能,安全有效,值得推广。
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