目的：探讨25G细针小剂量吗啡复合罗哌卡因腰麻在肛科手术中的应用效果。方法：选择2018年1月至2019年3月择期行肛肠科手术患者80例,ASA分级Ⅰ或Ⅱ级,BMI 18～24 kg/m_²,性别不限,将患者随机分为2组(n=40)：常规腰麻针罗哌卡因腰麻组(D₁组)和25G细针小剂量吗啡复合罗哌卡因组(D₂组)。记录2组患者术中、术后8 h 及术后12 h的VAS评分,记录术后4 h患者 Bromage 运动阻滞评分,记录2组患者的补救镇痛率、头痛、恶心、呕吐、皮肤瘙痒和术后尿潴留的发生情况。结果：与D1组比较,D2组患者的术中VAS评分、术后4 h Bromage 运动阻滞评分差异无统计学意义,术后8 h和12 h 的VAS评分和补救镇痛率降低(P<0.05),而头痛、恶心、呕吐和术后尿潴留的发生率差异无统计学意义。结论：25G细针小剂量吗啡复合罗哌卡因腰麻用于肛科手术患者可有效缓解术后疼痛,并发症少且安全性较好,利于患者术后早期康复。

Objective: To investigate the application effect of 25G small dose of morphine combined with ropivacaine for spinal anesthesia in patients undergoing anal surgery.Methods: Select 80 patients with surgery from January 2018 to March 2019, ASA grade I or II, BMI 18 to 24 kg/m2, gender-unlimited, and randomly divide the patient into 2 groups (n-40): regular lumbar needle robekain (D1 group) and 25G micro-injection small dose of morphine compound pyrifolde group (D2). The VAS scores of 2 groups of patients were recorded during surgery, 8 h after surgery, and 12 h after surgery, bromage movement block scores were recorded in patients with 4 h after surgery, and the remediation analgesic rate, headache, nausea, vomiting, itching of the skin, and urinary retention occurred after surgery in 2 groups. Results: Compared with the D1 group, the difference in intraoperative VAS score, postoperative 4 h Bromage movement block score was not statistically significant, the VAS score and remedial analgesicity were reduced (P 0.05) in the postoperative 8 h and 12 h, while the difference in incidence of headache, nausea, vomiting and postoperative urinary retention was not statistically significant. Conclusion: 25G small dose of morphine compound rojacain lumbar hemp can effectively relieve postoperative pain in patients with surgery, with fewer complications and better safety, which is beneficial to the patient"s early recovery after surgery。