腰麻与骶管麻醉应用于肛门手术74例

Spinal anesthesia or caudal anesthesia for anorectal surgery:An analysis of 74 cases

目的:比较腰麻与骶管麻醉在肛门手术中的效果.方法:回顾性分析2008-09/2012-05应用腰麻及骶管麻醉行肛门手术病例共74例,36例采用腰麻(腰麻组),38例采用骶管麻醉(骶麻组).两组性别、年龄、病种分类及手术时间等资料相比,P>0.05.比较两组麻醉效果、起效时间、术中心血管系统不良反应情况、术后尿潴留的发生、术后感觉恢复时间.结果:腰麻组与骶麻组麻醉效果满意率分别为95%和79%(P<0.05),腰麻组与骶麻组术中心血管系统不良反应的发生率分别为30.6%和5.3%(P<0.01),腰麻组与骶麻组的平均麻醉起效时间分别为1.98min和8.99min(P<0.01),腰麻组与骶麻组分别发生尿潴留4例、3例(P>0.05),腰麻组与骶麻组术后平均感觉恢复时间分别为324min和288min(P>0.05).结论:肛门手术中应用腰麻效果优于骶管麻醉,但术中应密切监测血压、心率情况,及时处理血流动力学的改变.

AIM：To observe the clinical effect of spinal anesthesia and caudal anesthesia in anorectal surgery. METHODS：Seventy-four patients who underwent anorectal surgery between September 2009 and May 2012 were reviewed retrospectively. The patients were divided into spinal anesthesia group （n = 36） and caudal anesthesia group （n = 38）. There were no significant differences in age, sex, illness, and operation time between the two groups. Anesthesia effect, onset time, cardiovascular complication, urinary retention, and time to sensory recovery were compared between the two groups. RESULTS：The rate of satisfaction with anesthesia effect was 95% in the spinal anesthesia group and 79% in the caudal anesthesia group （P 〈0.05）. The morbidity of cardiovascular complication was 30.6% in the spinal anesthesia group and 5.3% in the caudal anesthesia group （P 〈0.01）. The mean onset time was 1.98 min in the spinal anesthesia group and 8.99 min in the caudal anesthesia group （P 〈0.01）. Urinary retention occurred in 4 cases in the spinal anesthesia group and in 3 cases in the caudal anesthesia group （P 〈0.05）. Mean time to sensory recovery was 324 min in the spinal anesthesia group and 288 min in the caudal anesthesia group （P 〈0.05）. CONCLUSION：Spinal anesthesia has better clinical effect than caudal anesthesia when used in anorectal surgery, but the blood pressure and heart rate must be closely monitored and cardiovascular changes must be handled on time.