Comparison of saddle, lumbar epidural and caudal blocks on anal sphincter tone: A prospective, randomized study
Comparison of saddle, lumbar epidural and caudal blocks on anal sphincter tone: A prospective, randomized study
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DOI：
10.1177/0300060516659393
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发表时间：
2016-10-01
影响因子：
1.6
通讯作者：
Kim, Duk-Kyung
中科院分区：
文献类型：
--
作者：
Shon, Yoon-Jung;Huh, Jin;Kim, Duk-Kyung
目的应用肛肠测压法比较鞍式、腰硬膜外阻滞和尾侧阻滞对肛门括约肌张力的影响。方法择期肛肠手术行区域麻醉患者随机分为鞍区阻滞（SD）、腰区硬膜外阻滞（LE）和尾区阻滞（CD） 3组。在每次区域阻滞前和阻滞后30min分别进行肛门直肠测压。采用最大静息压力（MRP）和最大挤压压力（MSP）比较肛门括约肌运动阻滞程度。结果本研究共纳入49例患者，其中SD组18例，LE组16例，CD组15例。三个区域麻醉组对MRP的抑制百分比无显著差异。然而，SD组的MSP抑制百分比（83.613.7%）明显高于LE组（58.4 +/- 19.8%）和CD组（47.8 +/- 16.9%）。在所有组中，每个区域阻断后MSP的减少明显大于MRP。结论鞍座阻滞比腰硬膜外阻滞和尾侧阻滞更有效地抑制肛门括约肌张力。腰硬膜外阻滞和尾侧阻滞之间没有差异。
Objective To compare the effects of saddle, lumbar epidural and caudal blocks on anal sphincter tone using anorectal manometry.Methods Patients undergoing elective anorectal surgery with regional anaesthesia were divided randomly into three groups and received a saddle (SD), lumbar epidural (LE), or caudal (CD) block. Anorectal manometry was performed before and 30min after each regional block. The degree of motor blockade of the anal sphincter was compared using the maximal resting pressure (MRP) and the maximal squeezing pressure (MSP).Results The study analysis population consisted of 49 patients (SD group, n=18; LE group, n=16; CD group, n=15). No significant differences were observed in the percentage inhibition of the MRP among the three regional anaesthetic groups. However, percentage inhibition of the MSP was significantly greater in the SD group (83.613.7%) compared with the LE group (58.4 +/- 19.8%) and the CD group (47.8 +/- 16.9%). In all groups, MSP was reduced significantly more than MRP after each regional block.Conclusions Saddle block was more effective than lumbar epidural or caudal block for depressing anal sphincter tone. No differences were detected between lumbar epidural and caudal blocks.