超低剂量布比卡因联合芬太尼鞍区麻醉在肛门手术中的应用与围手术期护理

Perioperative nursing care and effect of saddle anaesthesia with ultra-low-dose bupivacaine combined with fentanyl to anal surgery

目的探讨超低剂量布比卡因联合芬太尼鞍麻应用于肛门手术的麻醉效果及围手术期护理价值。方法将ASAⅠ～Ⅱ级的肛门手术病人130例随机分为观察组和对照组,观察组注入用10%葡萄糖配制成的布比卡因2mg内含10μg芬太尼行鞍麻;对照组注入用10%葡萄糖配制成的布比卡因3 mg鞍麻。围手术期给与精心护理和健康教育,对护理资料进行归纳。结果两组病人镇痛效果相似(P>0.05),而对照组镇痛持续时间长于观察组(P<0.05)。手术后改良Bromage评分及不良反应观察组明显少于对照组(P<0.05)。围手术期病情稳定,无并发症发生。结论 2 mg布比卡因复合10μg芬太尼鞍区麻醉,镇痛效果更好而副作用小,比传统的鞍麻剂量更加安全。围手术期相关护理及健康教育能够保证该方法的顺利实施。

Objective ： To explore the effect and signification of perioperative nursing care of saddle anaesthesia with ultra-low-dose bupivaeaine combined with fentanyl to anal surgery. Methods：ASA I - II grade 130 cases of patients scheduled for anal surgery were randomly divided into the observation group and the control group. The pastionts of the observation group were saddle anaesthesised with 2 μg bupivacaine combined with fentanyl 10μg. The patients of the control group were saddle anaesthesised with 3 mg bupivacaine. The data resulting from the cases with perioperative nursing care and heahheare education experiences was reviewed retrospectively. Results ： Analgesic effect of two groups of patients was similar. Adverse reactions of observation group were significantly less than those of the control group. The patients were comfortable. There was no complication. Conclusion：Saddle anesthesia with 2 mg bupivacaine combined with 101xg fentanyl is more suitable for anal surgery than the traditional saddle anesthesia. The proper perioperative nursing care and healtheare education is important for the success of the procedure.