摘要
目的 探讨研究硬膜外麻醉中麻醉不全或失效的手术病人是否仍然可以利用原硬膜外麻醉持续硬膜外腔注药进行术后镇痛,并取得良好镇痛效果。方法 设置实验组30例都是硬膜外麻醉效果差或者无效,而且术中使用辅助静脉麻醉药品,甚至改换别种麻醉方式才能进行手术的。对照组30例是硬膜外麻醉效果良好不需要静脉麻醉辅助。两组病例都是妇科手术病人在硬膜外麻醉下进行手术。术后两组病人都进行48小时持续硬膜外注药进行镇痛,使用镇痛主要药品是吗啡。结果 两组病例术后48小时镇痛效果无显著性差异(P>0.05),术后分别24小时、48小时静脉抽血检测血中吗啡浓度各一次,无显著性差异(p>0.05),血流动力学、呼吸、氧饱和度两组无统计学意义(P>0.05)。实验组中硬膜外麻醉不全或失效中10例进行X线拍片造影证实有的硬膜外导管在椎间孔;有的硬膜外导管在硬膜外腔中螺旋弯曲打折,或者进入硬膜腔太短仅1厘米左右;有的硬膜外导管虽然在硬膜外腔长度3厘米以上,但由于硬膜外腔造影剂不扩散或者扩散范围太少;有的硬膜外导管不在硬膜外腔仅在一些神经根附近。结论 硬膜外麻醉与硬膜外镇痛、药物扩散范围、麻醉效果与镇痛效果,不是完全相同的,并且作用机理互相之间都有差别。所以提出看法是进行持续硬膜术后镇痛,不一定要良好硬?
objective Every lying-in woman have to undergo the suffering in parturition. Thepurpose of this study was to lighten or remove the pain in parturition with the minimally interferenceto parturient process, lying-in woman herselves, fetus, and the pattern of parturition. Method Apllylow density bupivacainum and small amount Fentaye in thirty lying-in women as the obsened group. When theexit of uterus opens to 2 cms, apply conbined lumbar spinal-epidural anesthesia in the observed group.The other thirty first lying in women who have not ask painless parturition was the Contrastive group.Both groups haven’t any obstetric or anesthesia contr ainclication and definitely can carry out voyinalparturition.Result The higeincidencee of painless parturtion(P<0.01), the faster cervicaldilation,shorter active period(P<0.05). Conclusion The outside town of outside anaesthesia and extrndural spaceof extrndural space is painful, medicine scope, anaesthesia result and painful result in town, is notcomplete same alike of , and function machine the mutual all contain difference. Do not, The refore bringup the view point to proceed to keep on the extrndural space the empress of town painful, not necessarilywant the outside anaesthesia result of good extrndural space, The outside anaesthesia of extrndural spaceis not all or expired after can proceed to keep on the outside of extrndural spac the town is painful,and after acquiring the good painful result(P<0.05),but the higher incidence of viginal aid childbirth(P<0.005) in observed obserued group than in contrastive group, and there was no difference in the otherrespeds , Incondusion, Conbined lumbar spinal-epidural anothers is one of the ideal methods in painlessparturition.
出处
《国际医药卫生导报》
2003年第22期13-15,共3页
International Medicine and Health Guidance News
关键词
硬膜外麻醉
术后镇痛
吗啡
Epidural anesthesia Posoperative analgesia Morphia
