不同剂量及注药方向罗哌卡因对肛肠手术者进行蛛网膜下腔阻滞的效果及安全性分析

Influence and safety analysis of Ropiracaine at Different Doses and Infusion Directions on Subarachnoid Block Efficacy in Patients Undergoing Coloproctological Surgery

为探讨不同剂量及注药方向罗哌卡因对肛肠手术者进行蛛网膜下腔阻滞的效果及安全性,选择2018年2月至2019年5月拟于我院在蛛网膜下腔阻滞下行手术治疗的120例肛肠病患者作为研究对象,根据罗哌卡因用量及注药方向分为4组,即8mg向头端注药组(简称H8组)、8mg向尾端注药组(简称T8组)、10mg向头端注药组(简称H10组)、10mg向尾端注药组(简称T10组),每组30例。比较4组患者感觉阻滞起效时间(OTSB)及恢复时间(RTSB)、运动阻滞恢复时间(RTMB),以及不良反应发生情况。结果显示,1)OTSB:H10组、T10组OTSB明显短于H8组和T8组,P<0.05;H10组与T10组间及H8组与T8组间OTSB比较差异无统计学意义,P>0.05。2)RTSB和RTMB:H10组、T10组RTSB和RTMB明显长于H8组和T8组,差异有统计学意义,P<0.05;H10组RTSB和RTMB略短于T10组,H8组RTSB略短于T8组,T8组RTMB略短于H8组,但差异均无统计学意义,P>0.05。3)不良反应:2组均未出现恶心呕吐、头痛病例,均出现尿潴留、腰部不适病例。各组间比较,T8组尿潴留、腰部不适发生率最低。结果表明,罗哌卡因8mg向尾端注射行蛛网膜下腔阻滞,对肛肠手术者的麻醉效果最好,安全性最高。

This study was to investigate the efficacy of ropiracaine at difference doses and infusion directions for subarachnoid block in the patients undergoing coloproctological surgery,and to analyse its safety,enrolled 120patients to be subject to coloproctological surgery in author's hospital(2018-02-2019-05)as research subjects,according to the dose and infusion direction of ropiracaine divided them into four groups:H8group(i.e,8mg,head towards),T8group(8mg,terminal towards),H10group(10mg,head towards)and T10group(10mg,terminal towards),30cases per group;then,compared OTSB,RTSB and RTMB,as well as untoward reaction incidence between the four groups.As results,1)OTSB:H10group and T10group were significantly shorter than H8group and T8group(P<0.05);but there was no statistical difference between H10group and T10group,as well between T8group and H8group(P>0.05).2)RTSB and RTMB:H10group and T10group were significantly longer than H8group and T8group(P<0.05),and H10group was slightly shorter than T10group(P>0.05);but,in RTSB H8group was slightly shorter than T8group(but P>0.05),in RTMB T8group was slightly shorter than H8group(but P>0.05).3)Untoward reaction:no nausea&vomiting,and headache were found in the two groups,but uroschesis and waist unwell were all found in the two groups,merely,their incidences was most lower in T8 group.Results show that when 8mg,teminal towards injusion of ropiracaine for subarachnoid block can achieve best anesthesia efficacy amidst coloproctological surgery and it has the highest safety.