Abstract
目的 研究不同浓度与容量的布比卡因对肛肠手术脊麻效应的影响.方法 180例ASA Ⅰ～Ⅱ级接受肛肠手术患者,随机分三组,每组60例.脊麻均选择L3～4间隙穿刺.Ⅰ组取坐位穿刺,用0.75%布比卡因0.6 ml;Ⅱ、Ⅲ组均取侧卧位穿刺,分别注入0.1%布比卡因5 ml、4 ml.结果麻醉效果:三组麻醉效果均满意,未加任何辅助药完成手术.麻醉起效、消退时间,各组间比较无差异(P＞0.05).阻滞平面:Ⅰ组阻滞平面最低(L5);Ⅱ组阻滞平面最高(L2);Ⅲ组阻滞平面在L3.Ⅱ、Ⅲ组与Ⅰ组比较差异显著(P＜0.01).术后不良反应:Ⅰ组头痛、头晕12例(20%),Ⅱ、Ⅲ组无头痛、头晕病例.尿潴留Ⅰ组15例(25%);Ⅱ组3例(5%);Ⅲ组1例(1.67%),Ⅱ、Ⅲ组与Ⅰ组比较差异显著(P＜0.01).结论在肛肠手术脊麻中0.1%布比卡因4 ml比0.75%布比卡因0.6 ml不良反应如头痛、头昏、尿潴留等发生率明显低, 术后可早期活动,早出院。
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