小剂量等比重不同阻滞平面腰麻用于肛肠手术的临床效果比较

Comparison of clinical effects of small-dose isobaric solution for lumbar anesthesia at different blocking planes in anorectal surgery patients

目的比较小剂量等比重腰麻在控制不同阻滞平面用于肛肠手术的临床效果.方法将120例拟行肛肠手术的患者随机分为C组(常规腰麻,n=60)和L组(低平面腰麻,n=60).C组患者左侧卧位下向头部方向正常速度推注5 mg0.375%等比重布比卡因,麻醉平面在T12水平;L组采用相同体位下小剂量布比卡因向尾部方向缓慢注药,控制麻醉平面于L5水平.对比2组镇痛持续时间、自主排尿恢复时间、下肢运动阻滞情况、尿潴留等不良事件发生情况.结果2组均顺利完成手术.与C组比较,L组患者镇痛持续时间较长,对下肢运动阻滞影响更小(P<0.05).2组不良反应差异无统计学意义(P>0.05).结论小剂量等比重腰麻在控制较低麻醉平面患者有较好的效果,能够保持下肢运动功能,提高患者舒适度.

Objective To observe the clinical effects of lumbar anesthesia with small-dose isobaric solution in controlling different blocking planes for anorectal surgery.Methods A total of 120 patients treated by anorectal surgeries were randomly divided into group C(conventional lumbar anesthesia,n=60)and group L(low-plan lumbar anesthesia,n=60).At left lateral position,the patients in group C were injected with bupivacaine at an equal proportion of 5 mg 0.375%and normal speed to the head,and the anesthetic plane was at the level of T 12.Group L was slowly injected by bupivacaine to the tail direction with the same lower dose at the same position,with anesthetic plane of L 5.The duration of analgesia,recovery time of spontaneous urination,block condition of lower limb movement and incidence of complications such as urinary retention were compared between the two groups.Results The operations were successfully completed in both groups.Compared with group C,the duration of analgesia in group L was longer and motor block for lower limb was less(P<0.05).There were no significant differences in incidence of complications in two groups(P>0.05).Conclusion Small-dose isobaric solution in controlling lower blocking planes for anorectal surgery has better efficacy,which can maintain lower limb movement function,and improve patients′comfort degree.