直肠手术的麻醉支持系统

G. A. Myshkov, M. V. Abritsova, N. R. Torchua
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引用次数: 0

摘要

介绍。痔疮的发病率为每1000名成年人中有200人,其中75%是从事职业活动的人。麻醉支持的选择不仅影响手术的效果,而且影响术后早期的病程。同时,无论使用何种类型的神经轴阻滞,大多数作者指出在术后期间会出现急性尿潴留和严重的术后疼痛综合征等并发症。验证和评估所建议的肛肠手术麻醉支持系统的有效性。材料和方法。这项研究对100名患者进行了研究,他们被分为两组,每组50人。手术在复合麻醉(脊髓麻醉+药物镇静)条件下进行。脊髓麻醉采用0.5%等压布比卡因溶液,平均剂量为8.5±0.12 mg。对于药物镇静,持续输注异丙酚,目标浓度为5-4-3 mg/kg / h。纳入主组的标准是术后早期预约使用α - 1肾上腺素阻滞剂盐酸坦索罗辛,剂量为0.4 mg/d。结果和讨论。麻醉支持系统,包括7.5 ~ 10.0 mg布比卡因等压溶液脊柱麻醉和目标浓度为5-4-3 mg/kg / h的异丙酚静脉镇静,基于多向药物联合作用的术后麻醉方案和0.4 mg/d的α - 1肾上腺素阻滞剂盐酸坦索罗辛的指定,保证了高质量和安全的手术治疗。给药剂量为0.4 mg的盐酸坦索罗辛可防止患者发生急性尿潴留。
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The system of anesthesiological support for coloproctological operations
Introduction. The prevalence of hemorrhoidal disease is 200 people per 1000 adult population, of which 75% are professionally active people. The choice of anesthetic support affects not only the effectiveness of the operation, but also the course of the early postoperative period. At the same time, regardless of the use of various variants of neuroaxial blockades, most authors indicate the development of complications such as acute urinary retention and severe postoperative pain syndrome in the postoperative period.Aim. To substantiate and evaluate the effectiveness of the proposed system of anesthesiological support for proctological operations.Material and methods. The study was conducted in 100 patients who were divided into two groups of 50 people. The operations were performed under conditions of combined anesthesia (spinal anesthesia + medical sedation). Spinal anesthesia was achieved with 0.5% isobaric bupivacaine solution, the average dose was 8.5 ± 0.12 mg. For drug sedation, a continuous infusion of propofol was used at a target concentration of 5–4–3 mg/kg per hour. The criterion for including patients in the main group was the appointment in the early postoperative period of the alpha 1 adrenoblocker tamsulosin hydrochloride at a dose of 0.4 mg/day.Results and discussion. The system of anesthetic support, including a combination of spinal anesthesia using an isobaric solution of bupivacaine at a dose of 7.5 to 10.0 mg and intravenous sedation with propofol at a target concentration of 5–4–3 mg/kg per hour, program of postoperative anesthesia based on a combination of multidirectional drug action and the appointment of alpha 1 adrenoblocker tamsulosin hydrochloride at a dose of 0.4 mg/day allows for high-quality and safe surgical treatment.Conclusion. The administration oftamsulosin hydrochloride at a dose of 0.4 mg prevented the development of acute urinary retention of patients. 
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