腰麻联合硬膜外麻醉在子宫切除术中的应用

    Application of combined epidural-spinal anesthesia in hysterectomy

    • 摘要: 目的: 比较硬膜外麻醉(EA)和腰硬联合麻醉(CSEA)在子宫切除术中循环系统及镇痛效果和不良反应的情况。方法: 选择60例ASAⅠ~Ⅱ级患者,随机分为单纯硬膜外麻醉组(A组,30例)和腰硬联合麻醉组(B组,30例)。术中监测BP、HR、SpO2,观察镇痛效果及牵拉反应情况。结果: 两组患者术中血流动力学较平稳,BP均较麻醉前降低。但B组下降明显(P<0.01)。B组患者骶神经阻滞完善,术中未见恶心、呕吐等不良反应,A组部分患者手术牵拉时诉疼痛,恶心、呕吐、鼓肠、腹肌紧张等内脏牵拉反应均较B组明显(P<0.05~P<0.005)。结论: 腰硬联合麻醉起效快,肌松完善,不良反应小,是一种值得推广的麻醉方法。

       

      Abstract: Objective: To compare the antalgic effect,the fluctuation of the circulatory system and the side effects of combined spinal-epidural anesthesia and the epidural anesthesia in hysterectomy.Methods: Sixty patients undergoing elective ASA ⅠorⅡsection were divided randomizedly into two groups:group A(n=30) received simple epidural anesthesia;group B(n=30) received combined epidural-spinal anaesthesia.BP,HR and SPO2 were monitored.The antalgic effect and the traction reflex were observed.Results: Homodynamics was relatively stable.BP was decreased after the anaesthesia in two groups,which was more significantly in group B.The sacral nerve was blocked perfectly in patients of group B without disgusting and vomiting in operation while some patients of group A complained about pains with the viscera traction reflex such as disgusting,vomiting,distension of the intestine and the tension of the abdominal muscles in operation(P<0.05 to P<0.005).Conclusions: The effect arises fast in combined spinal-epidural anaesthesia with better muscle relaxation and less side effects.This anaesthesia method is worth promoting.

       

    /

    返回文章
    返回