不同剂量罗哌卡因应用于肛肠手术蛛网膜下腔麻醉的效果

Effect of Different Doses of Ropivacaine on Subarachnoid Anesthesia in Anorectal Surgery

目的:探讨肛肠手术中罗哌卡因剂量变化对手术效果的影响。方法:选取2022年3月—2023年5月玉屏侗族自治县中医院肛肠手术患者120例作为研究对象,按照随机原则分为A组、B组、C组,各40例。三组均采用罗哌卡因进行蛛网膜下腔麻醉,A组0.75%罗哌卡因15mg,B组0.75%罗哌卡因10mg,C组0.75%罗哌卡因7.5mg。比较三组麻醉阻滞情况、运动阻滞程度、平均动脉压(MAP)、心率(HR)、不良反应、护理满意率。结果:B组、C组运动阻滞时间长于A组,最高阻滞平面低于A组,麻醉后5、15、30 min B组和C组MAP高于A组,麻醉后15 min B组和C组HR高于A组,差异有统计学意义(P<0.05);A组不良反应发生率高于B组和C组,A组、B组总满意率高于C组,差异有统计学意义(P<0.05)。结论:0.75%罗哌卡因10 mg在肛肠手术蛛网膜下腔麻醉中应用效果较好,有利于患者血流动力学稳定,安全性好,患者满意度较高。

Objective:To investigate the effect of dose change of ropivacaine on operation results in anorectal surgery.Methods:A total of 120 patients undergoing anorectal surgery were selected as the research subjects in the Yuping Dong Autonomous County Hospital of Traditional Chinese Medicine from March 2022 to May 2023,and divided into group A,group B,and group C according to the random principle,with 40 cases in each group.All three groups used ropivacaine for subarachnoid anesthesia,group A 0.75%ropivacaine 15 mg,group B 0.75%ropivacaine 10 mg,and group C 0.75%ropivacaine 7.5 mg.The anesthesia block conditions,degree of motor block,mean arterial pressure(MAP),heart rate(HR),adverse reactions,and nursing satisfaction rate were compared among the three groups.Results:The time of motor block in groups B and C was longer than that in group A,the maximum block plane was lower than that in group A,the MAP in groups B and C was higher than that in group A 5,15 and 30 minutes after anesthesia,and the HR in groups B and C was higher than that in group A 15 minutes after anesthesia,the difference was statistically significant(P<0.05);the incidence of adverse reactions in group A was higher than that in group B and group C,and the total satisfaction rate in group A and group B was higher than that in group C,with statistical significance(P<0.05).Conclusion:The application of 0.75%ropivacaine 10 mg in subarachnoid anesthesia in anorectal surgery has a good effect,which is conducive to stable hemodynamics,good safety and high patient satisfaction.