摘要
目的观察不同剂量的布比卡因腰硬联合麻醉用于大隐静脉高位结扎抽剥联合曲张静脉TriVex术的麻醉效果。方法选择单侧下肢静脉曲张患者120例,随机分为4组:3 mg布比卡因腰硬联合麻醉(A组),4 mg布比卡因腰硬联合麻醉(B组)、5 mg布比卡因腰硬联合麻醉(C组)和7 mg布比卡因腰硬联合麻醉(D组)。观察各组生命体征、最高痛觉阻滞平面、2%利多卡因硬膜外追加量、排尿时间、术后尿潴留发生率和麻醉效果。结果最高痛觉阻滞平面D组明显高于A、B、C组(P <0.05);首次给药后B、C、D组均能满足手术,A组需硬膜外追加利多卡因才能满足手术;排尿时间D组明显长于A、B、C组(P <0.05);术后尿潴留A、B均无发生,C、D组均有发生,且D组明显多于C组(P <0.05);麻醉效果B、C、D组均为优级,优级数明显多于A组(P <0.05)。结论大隐静脉高位结扎抽剥联合曲张静脉TriVex术建议选择重比重布比卡因4 mg腰硬联合麻醉,该方法起效快速、经济实惠、副作用少及效果确切,更能体现精准麻醉理念。
Objective To observe the anesthetic effect of different doses of bupivacaine combined spinalepidural anesthesia for high ligation and stripping of great saphenous vein combined varicose vein Trivex.Methods One hundred and twenty patients with unilateral lower extremity varices were randomly divided into group A(3 mg bupivacaine combined spinal-epidural anesthesia),group B(4 mg bupivacaine Combined spinal-epidural anesthesia),group C(5mg bupivacaine combined spinal.epidural anesthesia)and group D(7mg bupivacaine combined spinal-epidural anesthesia).Changes in vital signs,highest pain block level,2%lidocaine volume of epidural,urinating time,postoperative urinary retention rate,and anesthetic effect were observed.Results The highest pain.inhibitory level was significantly higher in group D than that in group A,B and C(P<0.05).Except for group A,in which additional epidural anesthetics were needed,all other groups were able to meet the requirement of the operation.The voiding time of group D was significantly longer than that of group A,B and C(P<0.05);Postoperative urinary retention did not occur in group A and B,but in group C and D,and there were more urine in group D than that in group C(P<0.05).The anesthetic effects in group B,C and D were all excellent,and the ecellent cases are obviously more than group A.Conclusion Being rapid,economical and with few side effect and exact effect,4 mg heavy proportion bupivacaine combined spinal.epidural anesthesia is recommended for high ligation and stripping of great saphenous vein combined varicose vein Trive and it can reflect the concept of precision anesthesia.
作者
姚活锋
黄焕森
YAO Huofeng;HUANG Huansen(Department of Anesthesiology the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第22期3709-3712,共4页
The Journal of Practical Medicine
关键词
大隐静脉高位结扎抽剥
麻醉方式
新探讨
high ligation and stripping of great saphenous vein
anesthesia method
new study
