【摘要】 目的观察3种椎管内麻醉方式用于痔上黏膜环切吻合术(procedure for prolapse and hemorrhoids,PPH)的镇痛效果和不良反应。方法选取2008年1月至2009年1月实施痔上黏膜环切吻合术患者90例,随机分为持续硬膜外麻醉(A)组、脊椎麻醉(B)组、骶管阻滞复合静脉滴注丙泊酚(C)组,每组30例。分别记录每组术前、术中、术后的血压、心率、血氧饱和度;将麻醉效果进行分级,观察并记录麻醉镇痛效果;观察术后12 h内患者不良反应发生情况。结果 B组和C组镇痛效果明显优于A组(P<0.05),而B组和C组之间镇痛效果比较无明显差异(P>0.05)。此外,B组不良反应出现最多,共20例(66.67%),A组和C组不良反应均为9例(30.00%),B组不良反应发生率明显高于A组和C组(P<0.05)。结论骶管阻滞复合丙泊酚静脉滴注麻醉操作简单、安全有效、麻醉质量高且不良反应相对较少,可作为痔上黏膜环切吻合术患者的首选麻醉方式。更多还原

【Abstract】 Objective To evaluate the effect of caudal anesthesia combined with intravenous propofol during procedure for prolapse and hemorrhoids(PPH),by comparing the anesthetic effects and adverse reactions among three intraspinal anesthesia Methods.Methods Ninty patients undergoing PPH from January 2008 to January 2009 were selected and randomly divided into three groups(n=30),epidural anesthesia(A),spinal anesthesia(B) and caudal anesthesia combined with intravenous propofol(C).The vital signs including blood pressure(BP),heart rate(HR) and oxygen saturation parameters in each group were recorded preoperatively,intraoperatively and postoperatively.The anesthetic effects were graded.The anesthetic and analgesic effects were observed and recorded.Adverse reactions within postoperative 12 h were observed.Results The analgesic effects in the group B and C was significantly superior to the group A(P < 0.05,P < 0.05),whereas no obvious difference was found between the group B and C(P < 0.05).Additionally,the incidence rate of adverse reactions in the group B was significantly higher than that in the group A and C(20 cases,66.67%,P < 0.05).There were 9 cases(30.00%) in A and C groups,respectively.Conclusion Caudal anesthesia combined with intravenous propofol is easy to operate,safe,effective with high anesthetic quality and relatively less adverse reactions,which may be used as a preferable intraspinal anesthesia method in PPH.更多还原