摘要
目的探讨双侧阴部神经阻滞及局部麻醉(简称局麻)用于痔切除术的效果观察。方法选取2019年1月至2022年1月西安市中医医院收治的100例行痔切除术的患者作为研究对象。采用随机数字表法将所有患者分为观察组及对照组,每组50例。对照组采用局麻,观察组采用双侧阴部神经阻滞麻醉。比较两组围术期指标(手术时间、术中出血量、住院时间)及肛门内收缩压变化,采用疼痛视觉模拟评分法(VAS)评估两组术后疼痛程度,比较两组术中丙泊酚用量、相关并发症及不良反应情况。结果观察组手术时间明显短于对照组(P<0.05),但两组术中出血量、住院时间比较,差异均无统计学意义(P>0.05)。两组术前肛门收缩压、术前最大自主性收缩压比较,差异均无统计学意义(P>0.05);观察组麻醉后肛门收缩压明显低于对照组(P<0.05)。观察组疼痛程度低于对照组(Z=2.040,P<0.05)。观察组苏醒时间、术中丙泊酚用量均低于对照组(P<0.05)。两组术中呼吸抑制、术中心血管不良事件、术后尿潴留的发生率比较,差异均无统计学意义(P>0.05)。结论与局麻相比,双侧阴部神经阻滞麻醉可减轻痔切除术患者疼痛,改善肛门压力,且术中镇静剂用量较少。
Objective To investigate the effect of bilateral pudental nerve block and local anesthesia on hemorrhoidectomy.Methods On hundred patients with hemorrhoid resection admitted to Xi′an Municipal Hospital of Traditional Chinese from January 2019 to January 2022 were selected as the research subjects.All patients were divided into the observation group and control group by using the random number table method,50 cases in each group.The control group adopted the local anesthesia,while the observation group adopted the bilateral pudental nerve block.The perioperative indicators(surgical time,intraoperative bleeding,amount,hospital stay duration)and changes in anal systolic pressure were compared between the two groups.The pain visual analogue scale(VAS)was used to evaluate the degree of postoperative pain in the two groups.The amount of propofol during surgery,related complications and adverse reactions were compared between the two groups.Results The surgical time in the observation group was significantly lower than that in the control group(P<0.05),but there was no statistically significant difference in intraoperative bleeding amount and hospital stay duration between the two groups(P>0.05).There was no statistically significant difference in preoperative anal systolic pressure and preoperative maximum autonomous systolic pressure between the two groups.After anesthesia,the anal systolic pressure in the observation group was significantly lower than that in the control group(P<0.05).The degree of pain in the observation group was lower than that in the control group(Z=2.040,P<0.05).The awakening time and intraoperative propofol dosage in the observation group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence rates of respiratory depression,cardiovascular adverse events and postoperative urinary retention between the two groups(P>0.05).Conclusion Compared with local anesthesia,the bilateral pudental nerve block could alleviate pain and improve the anal pressure in the patients undergoing hemorrhoidectomy,moreover the use amount of sedatives during surgery is relatively small.
作者
李西羊
刘洁
李丹
LI Xiyang;LIU Jie;LI Dan(Department of Anesthesiology,Xi′an Municipal Hospital of Traditional Chinese Medicine,Xi′an,Shaanxi 710021,China;Department of Anesthesiology,Shenmu Municipal Hospital,Yulin,Shaanxi 719399,China)
出处
《检验医学与临床》
CAS
2024年第12期1755-1758,共4页
Laboratory Medicine and Clinic
关键词
阴部神经阻滞
局部麻醉
痔切除术
镇痛
心肺不良事件
pudental nerve block
local anesthesia
hemorrhoid resection
analgesia
cardiopulmonary adverse events
