不同浓度罗哌卡因硬膜外麻醉在肛门直肠部手术中的应用观察

Application of various concentrations of ropivacaine in epidural anesthesia during anorectal operation

目的：观察不同浓度的罗哌卡因硬膜外麻醉在肛门直肠部手术的临床效果。方法：选择90例ASAⅠ～Ⅱ级肛门直肠手术患者，随机分为3组，分别给予浓度为I％（A组），0．5％（B组），0．375％（C组）的罗哌卡因。分别于术中比较3组镇痛效果、运动阻滞程度、尿潴留、血压下降等项目。结果：3组镇痛效果均满意，视觉模拟评分（VAS）差异无显著意义，但C组运动阻滞程度、尿潴留、血压下降显著低于A组（P〈0．05）。结论：下肢无力、尿潴留、血压下降C组明显少于A组，有显著性差异（P〈0．05），说明0．375％罗哌卡因低位硬膜外麻醉应用于肛门直肠部手术镇痛效果良好，下肢无力、尿潴留、血压下降发生率低，是用于肛门直肠部手术麻醉的适宜浓度。

Objective： To observe the effects of various concentrations of ropivacaine in epidural anesthesia during anorectal operation. Methods： Ninety patients with ASA Ⅰ～Ⅱ performed anorectal operation were randomly divided into 3 groups. They were anesthetized with 1% （A） , 0.5% （B） and 0. 375% （C） ropivaeaine solution, respectively. During operation, the analgesic effect, motor block level, urine retention, blood pressure, and other indicators were observed in all patients. Results： Satisfactory analgesic effects were observed in 3 groups. The visual analog score （VAS） was not different in 3 groups, but the motor block level, urine retention, blood pressure was significantly lower in group C than in group A（P 〈 0.05）. Conclusion： Ropivacaine at 0. 375% is a suitable concentration in epidural anesthesia during anorectal operation. This concentration has shown a satisfactory analgesic effect, and lower incidence of limb weakness, urinary retention and blood pressure lowing during the operation.