目的 探讨超声引导下骶管阻滞麻醉在肛肠手术中应用效果。方法 选取2017-01至2018-03医院行肛肠手术患者208例,随机分为超声组和对照组,每组104例。 超声组予以超声引导定位骶管阻滞麻醉,对照组以传统解剖定位骶管阻滞麻醉。分别记录两组患者的穿刺情况(穿刺时间、穿刺针调整次数、麻醉起效时间和痛觉消失时间)、麻醉成功率及患者满意度和麻醉后并发症情况。结果 超声组穿剌针调整(2.50±0.50)次,明显少于对照组的(5.00±1.00)次,差异有统计学意义(P<0.05);麻醉起效时间(2.85±1.30)min,明显短于对照组的(4.88±0.92)min;痛觉消失时间(4.85±1.24)min,明显短于对照组的(7.86±2.12)min,差异均有统计学意义(P<0.05);超声组麻醉Ⅰ级比率及麻醉成功率均明显高于对照组(P<0.05)。超声组麻醉Ⅲ级比率明显低于对照组,差异有统计学意义(P<0.05)。超声组出现血肿、出血和神经损伤相关并发症明显少于对照组,差异均有统计学意义(P<0.05)。结论 超声引导下骶管阻滞麻醉在肛肠手术中可准确定位,提高阻滞麻醉成功率,减少并发症,提高患者满意度。

Objective To explore the clinical effect of ultrasound-guided sacral block in anorectal surgery. Methods Between January 2017 and March 2018, 208 patients were selected for anorectal surgery in our hospital. These patients were divided into the ultrasound group (104 cases) and traditional group (104 cases) by random allocation. The ultrasound group received ultrasound guided localization of sacral block anesthesia and in the traditional group, sacral block anesthesia was located by traditional anatomy. The puncture conditions (the duration of puncture, numbers of times of needles were adjusted, onset time and duration of analgesia), success rate of anesthesia, satisfaction rate of patients and postoperative complications were recorded respectively in the two groups. Results The number of times needle penetration was adjusted was (2.50±0.50 vs 5.00±1.00), the onset time of anesthesia (2.85±1.30 vs 4.88±0.92) and the duration of analgesia was (4.85±1.24 vs 7.86±2.12)min in the ultrasound group, lower than those in the traditional group ( P<0.05).The duration of puncture of the ultrasound group was significantly longer than that of the traditional group (12.82±3.50 vs 5.73±2.12). The percentage of anesthesia level Ⅰ in the ultrasound group (63.5% vs 43.3%) and success rate of anesthesia (94.2% vs 83.7%) were significantly higher than those of the traditional group (P<0.05). The percentage of ultrasonic anesthesia level Ⅲ in the ultrasound group was significantly lower than in the traditional group (1.0% vs 7.7%), P<0.05. The incidence of hematoma (9.6% vs19.2%), bleeding (7.7% vs 18.3%)and neuroinjection-related complications (2.9% vs 9.6%) in the ultrasound group was significantly lower than that in the traditional group. Conclusions Sacral block anesthesia guided by ultrasonography can be accurately positioned in anorectal surgery to improve the success rate of block, reduce complications and increase patient satisfaction, which is worthy of clinical application.