不同浓度亚甲蓝联合罗哌卡因用于混合痔术后镇痛的疗效与安全性评估OA
Efficacy and Safety Assessment of Different Concentrations of Methylene Blue Combined with Ropivacaine for Postoperative Analgesia in Mixed Hemorrhoids
目的:比较0.1%与0.05%两种浓度亚甲蓝分别联合罗哌卡因用于混合痔术后镇痛的疗效及安全性.方法:选取我院2020年6月至2023年12月期间择期行混合痔手术的患者104例,按术毕镇痛方案不同分为观察组和对照组,每组各52例.观察组采用0.1%亚甲蓝与罗哌卡因的混合液行局部浸润注射,对照组采用0.05%亚甲蓝与罗哌卡因的混合液行局部浸润注射.术后第1、3、5、7、9、14天采用视觉模拟量表(VAS)评估患者疼痛程度,记录术后24 h后镇痛药物使用情况、创面愈合时间及尿潴留等不良反应发生情况,并进行对比分析.结果:术后第1、3、5、7、9天,观察组VAS评分均显著低于对照组,P<0.05;术后第14天2组VAS评分比较差异无统计学意义,P>0.05.2组术后24 h后镇痛药物使用情况、创面愈合时间比较,差异均无统计学意义,P>0.05.2组患者术后均未出现红肿、硬结、感染或异常感觉等不良反应;观察组与对照组尿潴留发生率分别为9.6%(5/52)和11.5%(6/52),2组比较差异无统计学意义,P>0.05.结论:0.1%亚甲蓝联合罗哌卡因局部注射,可有效减轻混合痔术后早期疼痛,延长镇痛持续时间,提高患者舒适度,且不增加局部及全身不良事件发生风险,具有良好的安全性和临床应用价值.
Objective To compare the efficacy and safety of two concentrations(0.1%and 0.05%)of methylene blue combined with ropivacaine for postoperative analgesia in mixed hemorrhoids.Methods A total of 104 patients who underwent elective mixed hemorrhoid surgery in our hospital from June 2020 to December 2023 were selected and divided into the observation group and the control group according to different postoperative analgesia schemes,with 52 cases in each group.The observation group was given local infiltra-tion injection of mixed solution of 0.1%methylene blue and ropivacaine,while the control group was treated with local infiltration injection of mixed solution of 0.05%methylene blue and ropivacaine.The Visual Ana-logue Scale(VAS)was used to assess the pain degree of patients on the 1st,3rd,5th,7th,9th and 14th days after operation.The use of analgesic drugs after 24 hours of operation,wound healing time and the occurrence of adverse reactions such as urinary retention were recorded and compared.Results On the 1st,3rd,5th,7th and 9th days after operation,the VAS scores of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in VAS scores between the two groups on the 14th day after operation(P>0.05).There were no significant differences in the use of analgesic drugs after 24 hours of operation and wound healing time between the two groups(P>0.05).No adverse reactions such as redness,induration,infection or abnormal sensation occurred in either group after operation.The incidence of urinary retention in the observation group and the control group was 9.6%(5/52)and 11.5%(6/52)respec-tively,and there was no significant difference between the two groups(P>0.05).Conclusion Local injec-tion of 0.1%methylene blue combined with ropivacaine can effectively reduce early postoperative pain of mixed hemorrhoids,prolong the duration of analgesia,improve patient comfort,and does not increase the risk of local and systemic adverse events,which has good safety and clinical application value.
曾涛;唐春蓉;毛华平
松滋市人民医院 肛肠科(湖北 松滋 434200)松滋市人民医院 麻醉科(湖北 松滋 434200)松滋市人民医院 普外科(湖北 松滋 434200)
混合痔术后镇痛亚甲蓝罗哌卡因浓度镇痛效果
Mixed hemorrhoidsPostoperative analgesiaMethylene blueRopivacaineConcentrationAnalgesic effect
《中国肛肠病杂志》 2026 (8)
55-57,3
评论