| 顾梦婷,黄浩,卢星,夏燕飞.超声引导下不同药物容量骶管麻醉在日间肛肠手术中的效果比较[J].浙江中西医结合杂志,2025,35(8): |
| 超声引导下不同药物容量骶管麻醉在日间肛肠手术中的效果比较 |
| Comparison of the effect of sacral canal anesthesia with different drug volumes under ultrasound guidance in daytime anorectal surgery |
| 投稿时间：2025-02-20 修订日期：2025-03-29 |
| DOI： |
| 中文关键词: 超声 骶管麻醉 日间肛肠手术 |
| 英文关键词:ultrasound caudal epidural block daytime anorectal surgery |
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| 中文摘要: |
| 【】目的 通过对超声引导下不同药物容量的骶管麻醉效果比较。方法 本研究采取单盲随机对照研究,选取2020年4月～2020年7月日间肛肠手术患者132例,随机分为A组(0.375%罗哌卡因15ml组,n=66)和B组(0.375%罗哌卡因20ml组,n=66),在超声引导下行采用骶管麻醉,比较两组的麻醉成功率,麻醉后感觉和运动的阻滞情况,术后6小时的感觉和运动阻滞情况,外科医生满意度,术后1小时、6小时、出院时NRS疼痛评分,术后留置导尿的概率,术后并发症。结果 A组与B组在麻醉成功率,麻醉后感觉和运动的阻滞情况,外科医生的满意度,术后1小时、6小时、出院时的NRS疼痛评分均无统计学差异。术后6小时的感觉平面A组低于B组P=0.01,术后6小时Bromage评分A组低于B组P=0.003,术后留置导尿的发生率A组低于B组P=0.031,两组术后均无并发症发生。结论 在0.375%罗哌卡因的浓度下,给予15ml容量的麻醉成功率非劣于20ml。15ml容量阻滞平面消退更快,下肢运动阻滞更少,术后导尿概率更低,适合日间肛肠手术。 |
| 英文摘要: |
| 【】Objective The effects of sacral canal anesthesia with different drug volumes under ultrasound guidance were compared. Methods In this study, 132 patients with daily anorectal surgery from April 2020 to July 2020 were selected and randomly divided into group A (0.375% ropivacaine 15ml group, n=66) and group B (0.375% ropivacaine 20ml group, n=66). Sacral canal anesthesia was administered under ultrasound guidance. The success rate of anesthesia, sensory and motor block after anesthesia, sensory and motor block 6 hours after surgery, surgeon satisfaction, NRS pain score 1 hour after surgery, 6 hours after surgery, the probability of postoperative induration catheterization, and postoperative complications were compared between the two groups.. Results There were no significant differences between group A and group B in the success rate of anesthesia, the sensory and motor block after anesthesia, the satisfaction of surgeons, and the NRS pain score 1 hour after surgery, 6 hours after surgery and at discharge. The sensory level of group A 6 hours after surgery was lower than that of group B (P=0.01), the Bromage score of group A 6 hours after surgery was lower than that of group B (P=0.003), and the incidence of postoperative induration catheterization in group A was lower than that of group B (P=0.031), and no complications occurred in both groups. Conclusion At the concentration of 0.375% ropivacaine, the success rate of 15ml volume anesthesia is not inferior to 20ml. The 15ml volume block plane has faster regression, less lower limb movement block, and lower probability of postoperative catheterization, which is suitable for daytime anorectal surgery and worthy of promotion in middle and clinical practice. |
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