低浓度盐酸罗哌卡因联合利多卡因、亚甲蓝用于肛门疾病手术镇痛效果探讨

Analgesic Effect of Low Concentration Ropivacaine Hydrochloride Combined with Lidocaine and Methylene Blue in Anal Surgery

目的观察剖析低浓度的盐酸罗哌卡因联合盐酸利多卡因、亚甲蓝用于肛门疾病手术局部浸润麻醉镇痛效果。方法将2021年3月至2023年3月我院肛肠科收治住院的120例成人患者,采用随机数字表法分为对照组、观察组,各60例。其中对照组采用2%盐酸利多卡因注射液5 ml+0.9%氯化钠注射液5 ml于肛缘行局部浸润麻醉,麻醉充分后行肛肠疾病手术,术毕予2%盐酸利多卡因注射液5 ml+0.9%氯化钠注射液5 ml联合1%亚甲蓝注射液2 ml行创面皮下环状封闭;观察组使用0.5%盐酸罗哌卡因注射液3 ml+2%盐酸利多卡因注射液5 ml+0.9%氯化钠注射液5 ml于肛缘行局部浸润麻醉,麻醉充分后行肛肠疾病手术,术毕予0.5%罗哌卡因和2%利多卡因各5 ml联合1%亚甲蓝注射液2 ml(混合液)稀释于0.9%氯化钠注射液5 ml里行创面皮下环状封闭,比较两组效果。结果观察组患者术中及术后1 h、3 h视觉模拟评分法(VAS)评分、并发症发生率(6.67%)均低于对照组(P<0.05)。结论低浓度盐酸罗哌卡因联合盐酸利多卡因、亚甲蓝注射液在肛门疾病手术镇痛效果更好、更安全、不良反应少。

Objective To observe and analyze the analgesic effect of low concentration ropivacaine hydrochloride combined with lidocaine hydrochloride and methylene blue for local infiltration anesthesia in anal surgery.Methods A total of 120 adult patients admitted to the anorectal department of our hospital from March 2021 to March 2023 were divided into control group and observation group by random number table method,with 60 cases in each group.In the control group,5 ml of 2%lidocaine salt and 5 ml of 0.9%sodium chloride were injected into the anal margin for local infiltration anesthesia,and the operation of anorectal diseases was performed after sufficient anesthesia.At the end of the operation,the wound was sealed with 2%Lidocaine Salt 5 ml+0.9%Sodium Chloride 5 ml and 1%Methylene Blue 2 ml.The observation group used 0.5%ropivacaine hydrochloride injection 3 ml+2%lidocaine hydrochloride injection 5 ml+0.9%sodium chloride injection 5 ml at the anal border for local infiltration anesthesia,anesthesia sufficient anorectal surgery,At the end of the operation,0.5%ropivacaine and 2%lidocaine were given 5 ml each combined with 1%methylene blue injection 2 ml(mixture)diluted in 0.9%sodium chloride injection 5 ml,to compare the effects of the two groups.Results Visual analogue scale(VAS)scores during and 1 and 3 hours after surgery,the incidence of complications(6.67%)in observation group were all lower than those in control group(P<0.05).Conclusions Low concentration of ropivacaine hydrochloride combined with lidocaine hydrochloride and methylene blue injection has better analgesic effect,safer and less adverse reactions in anal surgery.