JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (3): 117-120.doi: 10.6040/j.issn.1671-7554.0.2016.245

Previous Articles     Next Articles

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

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

CLC Number: 

  • R614.4
[1] 陈秋宇,吴文双,唐祖恩.小剂量布比卡因复合芬太尼用于椎管内麻醉的安全性和有效性Meta分析[J].临床麻醉学杂志,2016,32(1): 78-83. CHEN Qiuyu, WU Wenshuang, TANG Zuen. The safety and effectiveness of combination of low-dose bupivacaine with fentanyl for spinal anesthesia: a Meta-analysis of randomized trials[J]. Journal of Clinical Anesthesiology, 2016, 32(1): 78-83.
[2] 叶铁虎,王俊科,王祥瑞,等.下肢手术患者罗哌卡因与布比卡因蛛网膜下腔阻滞效果的比较前瞻性、多中心、随机、双盲研究[J].中华麻醉学杂志,2008,28(11):965-968. YE Tiehu, WANG Junke, WANG Xiangrui, et al. Comparison of efficacy of ropivacaine and bupivacaine for spinal anesthesia in patients undergoing unilateral lower limb surgery: a prospective, multicenter, randomized, double-blind study [J]. Chinese Journal of Anesthesiology, 2008, 28(11): 965-968.
[3] 张宁,徐铭军.蛛网膜下腔输注舒芬太尼用于分娩镇痛的临床效果[J].中华麻醉学杂志,2013,33(1):65-68. ZHANG Ning, XU Mingjun. Clinical effects of continuous spinal anesthesia with sufentanil for labor analgesia[J]. Chinese Journal of Anesthesiology, 2013, 33(1): 65-68.
[4] Arkoosh VA, Palmer CM, Yun EM, et al. A randomized,double-masked,multicenter comparison of the safety of continuous intrathecal labor analgesia using a 28-gauge catheter versus continuous epidural labor analgesia[J]. Anesthesiology, 2008, 108(2): 286-298.
[5] Ronald DM.米勒麻醉学[M].7版.北京:北京大学医学出版社,2011: 942, 1632.
[6] 李娜,余凌,余锦芬,等.不同浓度舒芬太尼配伍左布比卡因用于剖宫产术后病人自控硬膜外镇痛效果的比较[J]. 中华麻醉学杂志,2013,33(9):1102-1105. LI Na, YU Ling, YU Jinfen, et al. Comparison of efficacy of patient-controlled epidural analgesia with different concentrations of sufentanil plus levobupivacaine after caesarean section[J]. Chinese Journal of Anesthesiology, 2013, 33(9): 1102-1105.
[7] 张涛,陈坚伟,徐康清,等.蛛网膜下腔注射罗哌卡因与布比卡因运动神经阻滞效力的比较[J].中华麻醉学杂志,2011,31(2):214-216. ZHANG Tao, CHEN Jianwei, XU Kangqing, et al. The potencies for motor block after intrathecal ropivacaine and bupivacaine[J]. Chinese Journal of Anesthesiology, 2011, 31(2): 214-216.
[8] 黄绍强,耿桂启,胡建英,等.妇科手术患者蛛网膜下腔注射布比卡因与左旋布比卡因运动阻滞效应的比较[J].中华麻醉学杂志,2009,29(8):682-684. HUANG Shaoqiang, GENG Guiqi, HU Jianying, et al. The potencies for motor block after intrathecal bupivacaine and levobupivacaine[J]. Chinese Journal of Anesthesiology, 2009, 29(8): 682-684.
[9] 陈睿,黄毅然,李文红,等.丙泊酚治疗骶管阻滞引起局麻药中毒的临床经验[J].国际麻醉学与复苏杂志,2012,33(1):34-42. CHEN Rui, HUANG Yiran, LI Wenhong, et al. Clinical experience of propofol in treatment of local anesthetic toxicity induced by sacral block[J]. International Journal of Anesthesiology and Resuscitation, 2012, 33(1): 34-42.
[10] Tang WX, Li JJ, Bu HM, et al. Spinal anaesthesia with low-dose bupivacaine in marginally hyperbaric solutions for caesarean section[J]. Eur J Anaesthesiol, 2015, 32(7): 493-498.
[11] Nelson KE, Rauch T, Terebuh V, et al. A comparison of intrathecal fentanyl and sufentanil for labor analgesia[J]. Anesthesiology, 2002, 96(5): 1070-1073.
[12] 刘继云,佘守章,邬子林,等.产妇鞘内注射舒芬太尼分娩镇痛的效应[J].中华麻醉学杂志,2005, 25(10): 768-770. LIU Jiyun, SHE Shouzhang, WU Zilin, et al. Intrathecal sufentanil for labor analgesia in parturients[J]. Chinese Journal of Anesthesiology, 2005, 25(10): 768-770.
[13] Van de Velde M, Dreelinck R, Dubois J, et al. Determination of the full dose-response relation of intrathecal bupivacaine, levobupivacaine, and ropivacaine, combined with sufentanil, for labor analgesia[J]. Anesthesiology, 2007, 106(1):149-156.
[14] 项小兵,马美娜,柳兆芳.舒芬太尼复合小剂量布比卡因蛛网膜下腔麻醉在老年患者手术中的应用[J].临床麻醉学杂志,2012,28(5):469-471. XIANG Xiaobing, MA Meina, LIU Zhaofang. The application of sufentanil combined with low-dose bupivacaine for spinal anesthesia in elderly patients [J]. Journal of Clinical Anesthesiology, 2012, 28(5): 469-471.
[15] Kumar S, Bajwa SJ. Neuraxial opioids in geriatrics: a dose reduction study of local anesthetic with addition of sufentanil in lower limb surgery for elderly patients [J]. Saudi Anaesth, 2011, 5(2): 142-149.
[16] Ben-David B, Frankel R, Arzumonov T, et al. Minidose bupivacaine-fentanyl spinal anesthesia for surgical repair of hip fracture in the aged [J]. Anesthesioloy, 2000, 92(1): 6-10.
[17] Ginosar Y, Mirikatani E, Drover DR, et al. ED50 and ED95 of intrathecal hyperbaric bupivacaine coadministered with opioids for cesarean delivery [J]. Anesthesiology, 2004, 100(3): 676-682.
[18] Wong CA. Advances in labor analgesia[J]. Int J Womens Health, 2010, 1: 139-154.
[19] 詹丽春,李建国,季称心,等.不同剂量舒芬太尼复合罗哌卡因腰麻联合硬膜外自控镇痛用于分娩镇痛的效果[J].临床麻醉学杂志,2013, 29(3): 295-296.
[1] ZHANG Xiao-Yan, LI Gang, WANG Ling-Beng. Effects of different dosages of Sufentanil in induced general anesthesia  period on blood rheology cortisol in spinal operations [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2209, 47(6): 76-79.
[2] ZHANG Xiao-Yan, LI Gang, WANG Ling-Beng. Effects of different dosages of Sufentanil in induced general anesthesia  period on blood rheology cortisol in spinal operations [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(6): 76-79.
[3] YU Ai-lan,FU Zhi-jian,ZHANG Zong-wang,CAI Xing-zhi,ZHANG Wei. [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(10): 1032-1035.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd