罗哌卡因椎管内麻醉联合芬太尼基础麻醉对痔切除患者麻醉效果观察OA

Objective To investigate the anesthetic efficacy and safety of ropivacaine intraspinal anesthesia combined with fentanyl basal anesthesia in patients undergoing hemorrhoidectomy.Methods Total 76 patients scheduled to undergo hemorrhoidectomy at our hospital from October 2023 to March 2025 were enrolled in this prospective study and randomly divided into the observation group and the control group,with 38 cases in each group.The observation group received ropivacaine spinal anesthesia combined with intrave-nous fentanyl,while the control group received ropivacaine spinal anesthesia alone.Hemodynamic parameters,Visual Analogue Scale(VAS)pain score,anesthetic effect,Ramsay score and adverse reactions at different time points were compared between the two groups.Results Heart rate(HR)and mean arterial pressure(MAP)at 10 min(T1),20 min(T2)and 30 min(T3)after anesthesia were significantly lower than those before anesthesia(T0)in both groups(P<0.05),with no statistically significant differences between the two groups(P>0.05).The VAS scores of the two groups increased gradually immediately after operation,at 0.5 h and 2 h after operation,and decreased gradually at 6 h,12 h and 24 h after operation.The VAS scores of the observation group at 0.5 h,2 h and 6 h after operation were significantly lower than those of the control group(P<0.05).The onset time of sensory block in the observation group was shorter than that in the control group,and the duration of sensory block was longer(P<0.05).There were no significant differences in the onset time and duration of motor block between the two groups(P>0.05).There was no significant difference in Ramsay score between the two groups(P>0.05).There was no significant difference in the incidence of perioperative adverse reactions between the two groups(P>0.05).Conclusion Ropivacaine intraspinal anesthesia combined with fentanyl basal anesthesia can effectively shorten the onset time of sensory block,pro-long the duration of analgesia,and significantly reduce early postoperative pain in hemorrhoidectomy.It has no significant effect on hemodynamics,motor block and sedation depth,with good safety,which is superior to ropivacaine spinal anesthesia alone.