不同剂量的0.5％布比卡因用于肛周手术的麻醉应激及耐受性观察

摘要

Objective To study effect of different doses of 0.5％ bupivacaine on stress reaction and tolerance during anesthesia for perianal surgery.Methods 102 patients who underwent perianal surgery in our hospital were included in the study and were randomly assigned to A,B,C groups,and were given 2.5mg,5mg and 7mg of 0.5％ bupivacaine,respectively,during lumbar anesthesia.The anesthesia onset time,anesthesia recovery time,anesthesia effect and motor nerve block effect were compared between groups.Changes of heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP)before injection and at different time points after injection and the incidence rates of adverse reactions were recorded.Results There were no significant differences in anesthesia onset time,anesthesia effect and motor nerve block effect between the three groups (P ＞ 0.05).The recovery time in group A and group B was shorter than that in group C (P ＜ 0.05).SBP,DBP and HR of group A did not changed after injection (P ＞ 0.05).SBP at 2 and 4 min after administration in group B was lower than that at baseline (P ＜ 0.05),and SBP in group C at different time points after administration were lower than that at baseline (P ＜ 0.05)and SBP at 4min and 6min after administration were lower than those in group A at the respective time points (P ＜ 0.05).The incidence rate of adverse reactions in group A (5.88％)was the lowest,and was significantly lower than that in group C (P ＜ 0.05).Conclusion 2.5mg of 0.5％ bupivacaine can achieve satisfactory anesthesia effect,with faster anesthetic recovery and stable vital.The adverse reactions are not comment and tolerable.%目的 观察不同剂量的0.5％布比卡因用于肛周手术的麻醉应激及耐受性.方法 选择2012年8月至2014年8月本院102例择期肛周手术患者为研究对象,随机分为A、B、C三组,分别给予0.5％布比卡因2.5 mg、5 mg、7 mg腰麻,比较三组麻醉起效时间、麻醉恢复时间、麻醉效果及运动神经阻滞效果,记录三组注药前及注药后不同时点的心率(HR)、收缩压(SBP)、舒张压(DBP)变化及不良反应发生率.结果 三组麻醉起效时间、麻醉效果及运动神经阻滞效果差异无统计学意义(P＞0.05).A、B组麻醉恢复时间短于C组(P＜0.05).A组注药后的SBP、DBP、HR无明显变化(P＞0.05);B组给药后2 min、4 min的SBP低于基线值(P＜0.05);C组注药后各时点的SBP均低于基线值(P＜0.05),其中注药后4 min、6 min的SBP低于A组相应时点(P＜0.05);A组不良反应发生率为5.88％,显著低于C组(P＜0.05).结论 0.5％布比卡因2.5 mg可获得满意的麻醉效果,且麻醉苏醒较快,给药后体征稳定,无严重机体应激表现,其不良反应少,患者耐受度高.