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复方亚甲蓝联合利多卡因骶管麻醉对肛肠手术患者术后应激指标的影响
Influence of Caudal Anesthesia with Compound Methylene Blue and Lidocaine on Stress Index of Patients Undergone Anorectal Surgery
  
DOI:
中文关键词:  亚甲蓝  利多卡因  骶管麻醉  肛肠手术  应激反应
英文关键词:Methylene blue  Lidocaine  Caudal anesthesia  Anorectal surgery  Stress reaction
基金项目:湖北省卫生厅科研项目(编号:JX6C-27)
作者单位
杜小宜1 杨刚2 1.三峡大学第二人民医院麻醉科 湖北宜昌 4430002.三峡大学仁和医院 
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中文摘要:
      摘 要 目的:探讨复方亚甲蓝联合利多卡因骶管麻醉对肛肠手术患者术后应激指标的影响。方法:采用回顾性研究方法,收集90例肛肠手术患者临床资料,根据麻醉用药不同分为观察组(n=45,行骶管注射复方亚甲蓝+利多卡因麻醉)和对照组(n=45,行骶管注射利多卡因麻醉)。对比两组术毕、术后3 h、12 h、24 h以及48 h时VAS评分差异,以及两组患者术前、术毕以及术后2 d时血清皮质醇(Cor)、去甲肾上腺素(NE)及肾上腺素(E)水平;观察两组术后胃肠功能恢复及并发症情况。结果:观察组患者术后各时点VAS评分均显著低于对照组(P<0.05)。与术前相比,两组患者术毕及术后2 d时血清Cor、NE以及E水平均显著升高,而观察组术毕及术后2 d时各应激指标均低于对照组(P<0.05)。观察组术后肠鸣音恢复时间、肛门排气时间以及排便时间均短于对照组(P<0.05),术后肛门失禁、肛门灼痛感以及肛缘水肿发生率均明显低于对照组(P<0.05)。结论:复方亚甲蓝联合利多卡因骶管麻醉能够有效降低肛肠手术患者术后疼痛,减轻机体应激反应,促进术后胃肠功能恢复和减少并发症的发生。
英文摘要:
      ABSTRACT Objective:To investigate the influence of caudal anesthesia with compound methylene blue and lidocaine on stress index of patients undergone anorectal surgery. Methods:Clinical data of 90 patients undergone anorectal surgery were retrospective analyzed. Those patients were divided into observation group (n=45, received caudal anesthesia with compound methylene blue + lidocaine) and control group (n=45, received caudal anesthesia with lidocaine) according to the anesthetic drugs. The difference of VAS score in two groups was compared at the end of surgery, 3 h, 12 h, 24 h and 48 h after surgery. The levels of serum cortisol (Cor), norepinephrine (NE) and epinephrine (E) were detected in two groups at preoperative, end and 2 d after surgery. The gastrointestinal function recovery and complications were observed in two groups. Results: The VAS scores in observation group were significantly lower than control group at all postoperative time points (P<0.05). Compared with preoperative, the serum Cor, NE and E levels in two groups were significantly increased at end of surgery and 2 d after surgery, while the ascending range of stress indexes in observation group were less than control group (P<0.05). Recovery time of bowel sounds, evacuation time and defecation time in observation group were shorter than control group (P<0.05). The occurrence rate of copracrasia, pain in anus and edema around anus in observation group were significantly lower than control group (P<0.05). Conclusion:Caudal anesthesia with compound methylene blue and lidocaine can effectively reduce postoperation pain of patients undergone anorectal surgery, reduce the stress response, promote postoperative gastrointestinal function recovery and reduce the incidence of complications.
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