罗哌卡因复合舒芬太尼在混合痔手术中的麻醉效果及不良反应影响

Anesthesia eff ect and adverse reactions of ropivacaine combined with sufentanil in mixed hemorrhoid surgery

目的探讨罗哌卡因复合舒芬太尼在混合痔手术中的麻醉效果及不良反应影响。方法选择2021年1月至2023年12月东莞市长安新安医院收治的混合痔并需择期手术者80例,根据随机数字表法分成观察组、对照组,各40例,患者均采用吻合器痔状黏膜环切术+外痔切除术。对照组采取罗哌卡因麻醉,观察组采取罗哌卡因复合罗哌卡因麻醉,持续监测术后1周时间。比较两组研究对象麻醉效果、麻醉阻滞、术后肛门收缩恢复及不良反应情况。结果两组患者在T0、T3时的生命体征指标水平无显著差异(P>0.05)。观察组患者在T1时的心率、收缩压、舒张压水平较T0时降低,而T1时与T0时的生命体征指标无显著差异。对照组在T1与T2时刻的心率、收缩压、舒张压水平均较T0时刻降低,观察组患者T1与T2时的生命体征指标均高于对照组,差异均有显著性(P<0.05)。观察组患者的感觉、运动阻滞的维持时间都短于对照组,差异均有显著性(P<0.05)。两组患者的感觉及运动阻滞起效时间无显著差异(P>0.05)。观察组患者的不良反应率显著低于对照组,且术后1周,观察组肛门收缩恢复率(92.50%)显著高于对照组(75.00%),差异有显著性(χ^(2)=4.500,P=0.034)。结论对于混合痔行手术治疗患者,手术过程中采取罗哌卡因复合舒芬太尼麻醉,相比单纯罗哌卡因麻醉,联合麻醉可以取得良好麻醉效果,缩短麻醉运动及阻滞时间,提高术后肛门收缩恢复率,且不良反应发生率低。

Objective To investigate the anesthetic eff ect and adverse reactions of ropivacaine combined with sufentanil in mixed hemorrhoid surgery.Method Eighty patients with mixed hemorrhoids who were admitted to Chang'an Xin'an Hospital in Dongguan City from January 2021 to December 2023 and required elective surgery were selected.They were randomly divided into an observation group and a control group,with 40 patients in each group.All patients underwent stapled hemorrhoidectomy and external hemorrhoidectomy.The control group was anesthetized with ropivacaine,while the observation group was anesthetized with ropivacaine combined with ropivacaine.The postoperative period was continuously monitored for one week.Compare the anesthesia eff ects,anesthesia blockade,postoperative anal contraction recovery,and adverse reactions between two groups of study subjects.Result There was no signifi cant diff erence in the levels of vital signs between the two groups of patients at T0 and T3(P>0.05).The heart rate,systolic blood pressure,and diastolic blood pressure levels of the observation group patients decreased at T1 compared to T0,while there was no signifi cant diff erence in vital sign indicators between T1 and T0.The heart rate,systolic blood pressure,and diastolic blood pressure of the control group decreased on average at T1 and T2 compared to T0.The vital sign indicators of the observation group were higher than those of the control group at T1 and T2,and the diff erences were signifi cant(P<0.05).The maintenance time of sensation and motor block in the observation group was shorter than that in the control group,and the diff erences were signifi cant(P<0.05).There was no signifi cant diff erence in the onset time of sensation and motor block between the two groups of patients(P>0.05).The incidence of adverse reactions in the observation group was signifi cantly lower than that in the control group,and one week after surgery,the recovery rate of anal contraction in the observation group(92.50%)was signifi cantly higher than that in the control group(75.00%),with a signifi cant diff erence(χ^(2)=4.500,P=0.034).Conclusion For patients undergoing surgery for mixed hemorrhoids,the combination of ropivacaine and sufentanil anesthesia during the surgery can achieve good anesthesia eff ects,shorten anesthesia movement and block time,improve postoperative anal contraction recovery rate,and have a low incidence of adverse reactions compared to simple ropivacaine anesthesia.