肛肠疾病患者术后使用罗哌卡因不同浓度硬膜外自控镇痛的效果观察

Observation on the effects of different concentrations of ropivacaine on epidural controlled analgesia in anorectal patients after operation

目的:观察肛肠疾病患者术后使用罗哌卡因不同浓度硬膜外自控镇痛的效果。方法:2018年2月-2020年2月收治肛肠疾病患者74例,均行手术治疗和硬膜外自控镇痛。根据罗哌卡因不同浓度分为两组,各37例。对照组采用0.08%罗哌卡因;观察组采用0.1%罗哌卡因。比较两组术后疼痛情况、恢复情况、运动阻滞程度和尿潴留发生率。结果:观察组术后4 h、8 h和16 h疼痛评分均低于对照组,差异有统计学意义(P<0.05)。观察组首次下床活动时间、首次排气排便时间、住院时间、运动阻滞程度评分和尿潴留发生率均低于对照组,差异有统计学意义(P<0.05)。结论:不同浓度罗哌卡因硬膜外自控镇痛均有良好的效果,但较高浓度罗哌卡因的镇痛效果更为显著,可促进肛肠疾病患者术后恢复,减少尿潴留发生。

Objective:To observe the effects of different concentrations of ropivacaine on epidural controlled analgesia in anorectal patients after operation.Methods:From February 2018 to February 2020,74 patients with anorectal diseases were selected and underwent surgical treatment and epidural controlled analgesia.According to different concentrations of ropivacaine,the patients were divided into two groups with 37 cases in each group.The control group received 0.08%ropivacaine.The observation group was treated with 0.1%ropivacaine.The postoperative pain,recovery,degree of motion retardation and incidence of urinary retention were compared between the two groups.Results:The pain scores of the observation group at 4 h,8 h and 16 h after surgery were all lower than the control group,the differences were statistically significant(P<0.05).The observation group was lower than the control group in terms of time of first out of bed activity,time of first exhaust and defecation,length of hospital stay,motor block score and incidence of urinary retention,the differences were statistically significant(P<0.05).Conclusion:Different concentrations of ropivacaine have good effects on epidural controlled analgesia,but the analgesic effects were more pronounced than high concentrations of ropivacaine,it can promote postoperative recovery of anorectal patients and reduce the incidence of urinary retention.