复方亚甲蓝注射液骶管麻醉在肛肠手术中的应用效果观察
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摘要
目的探讨复方亚甲蓝注射液骶管麻醉在肛肠手术中的应用效果。方法选取我院2015年10月至2017年2月收治的80例肛肠手术患者,随机平均分为两组。对照组经骶管注射17 m L 1%利多卡因,观察组经骶管注射17 m L复方亚甲蓝注射液。术后观察组常规处理手术创面,对照组于手术结束前在结扎基底部、创面基底以及肛周皮下注射10~20 m L复方亚甲蓝注射液。比较两组患者术后1 d、3 d、6 d、9 d、12 d后换药或排便时的VRS-4评分、并发症与药物的毒性反应。结果观察组术后各时间段的VRS-4评分均低于对照组(P<0.05)。两组患者的尿潴留、药物毒性反应发生率比较差异均无统计学意义(P>0.05)。观察组的肛门灼烧感、肛门失禁、肛缘水肿发生率均明显低于对照组(P<0.05)。结论对肛肠手术患者采用复方亚甲蓝注射液骶管麻醉方式,操作简单、安全,可明显减轻患者的术后疼痛,降低并发症发生率,值得临床推广应用。
Objective To study the application effect of caudal anesthesia with compound methylene blue injection in anorectal surgery. Methods 80 cases of patients with anorectal surgery admitted to our hospital from October 2015 to February 2017 were selected and randomly divided into two groups equally. The control group received caudal injection of 17 m L 1% lidocaine, while the observation group received 17 m L compound methylene blue injection. After the surgery, the observation group received conventional treatment for surgical wounds, while the control group was given 10 ~ 20 m L compound methylene blue subcutaneous injection in the basilar part of ligation,wound basement and crissum before the surgery completed. The VRS-4 scores when changing dressings or defecating on 1 d, 3 d, 6 d, 9 d and 12 d after surgery, complications and drug toxicity reactions were compared between two groups. Results The VRS-4 scores at different time of observation group after surgery were lower than those of control group(P <0.05). No statistical difference was found in the incidences of urinary retention and drug toxicity reactions(P >0.05). The incidences of burning sensation of anus, fecal incontinence and crissum edema of observation group were significantly lower than those of control group(P <0.05). Conclusions Caudal anesthesia with compound methylene blue injection in patients with anorectal surgery is simple and safe, and can significantly alleviate the postoperative pain and recude the incidence of complications, which is worthy of clinical promotion and application.
Objective To study the application effect of caudal anesthesia with compound methylene blue injection in anorectal surgery. Methods 80 cases of patients with anorectal surgery admitted to our hospital from October 2015 to February 2017 were selected and randomly divided into two groups equally. The control group received caudal injection of 17 m L 1% lidocaine, while the observation group received 17 m L compound methylene blue injection. After the surgery, the observation group received conventional treatment for surgical wounds, while the control group was given 10 ~ 20 m L compound methylene blue subcutaneous injection in the basilar part of ligation,wound basement and crissum before the surgery completed. The VRS-4 scores when changing dressings or defecating on 1 d, 3 d, 6 d, 9 d and 12 d after surgery, complications and drug toxicity reactions were compared between two groups. Results The VRS-4 scores at different time of observation group after surgery were lower than those of control group(P <0.05). No statistical difference was found in the incidences of urinary retention and drug toxicity reactions(P >0.05). The incidences of burning sensation of anus, fecal incontinence and crissum edema of observation group were significantly lower than those of control group(P <0.05). Conclusions Caudal anesthesia with compound methylene blue injection in patients with anorectal surgery is simple and safe, and can significantly alleviate the postoperative pain and recude the incidence of complications, which is worthy of clinical promotion and application.
引文
[1]韩庆丰,崔浩杰,边小松,等.复方亚甲蓝注射液骶管麻醉在肛肠手术中的应用[J].山东医药,2013,53(7):78-80.
[2]孙亚峰.中药坐浴熏洗联合复方亚甲蓝对肛肠术后疼痛的影响[J].国际中医中药杂志,2013,35(9):782-784.
[3]王煜永.复方亚甲蓝注射液在肛肠术后镇痛的临床观察[J].中国医学创新,2012,9(20):35-36.
[4]潘金娥,陈欢,姬偃修.亚甲蓝局部封闭联合中药熏洗治疗肛门瘙痒症的疗效观察[J].世界中医药,2013,8(8):893-895.
[5]孙涛,张西玲,贺向东.复方亚甲蓝注射液简化骶管麻醉在肛肠手术中的应用[J].陕西医学杂志,2009,38(6):740-741.
[6]曾永坚,赵威盛.肛肠手术新骶麻法麻醉57例效果观察[J].邯郸医学高等专科学校学报,2003,16(6):569-570.
[2]孙亚峰.中药坐浴熏洗联合复方亚甲蓝对肛肠术后疼痛的影响[J].国际中医中药杂志,2013,35(9):782-784.
[3]王煜永.复方亚甲蓝注射液在肛肠术后镇痛的临床观察[J].中国医学创新,2012,9(20):35-36.
[4]潘金娥,陈欢,姬偃修.亚甲蓝局部封闭联合中药熏洗治疗肛门瘙痒症的疗效观察[J].世界中医药,2013,8(8):893-895.
[5]孙涛,张西玲,贺向东.复方亚甲蓝注射液简化骶管麻醉在肛肠手术中的应用[J].陕西医学杂志,2009,38(6):740-741.
[6]曾永坚,赵威盛.肛肠手术新骶麻法麻醉57例效果观察[J].邯郸医学高等专科学校学报,2003,16(6):569-570.