摘要
目的探索脊椎硬膜外联合麻醉（ＣＳＥＡ）在剖宫产术中的的应用价值。方法以连续硬膜外麻醉（ＥＡ）为对照，将４０例健康足月产妇随机分为ＣＳＥＡ组和ＥＡ组，每组２０例，均于Ｌ２～３穿刺。ＣＳＥＡ组用带有背孔的Ｔｕｏｈｙ针和２６Ｇ腰穿针穿刺。结果①ＣＳＥＡ组有２例腰穿失败，但余１８例的麻醉效果明显优于ＥＡ组。②ＣＳＥＡ组局麻药用量显著减少（Ｐ＜０．０１），而麻醉平面明显广泛。③胎儿娩出后的手术时间相似，但麻醉诱导和胎儿娩出时间明显缩短（Ｐ＜０．０１）。④两组低血压（ＳＢＰ＜１０．３３ｋＰａ）发生率相似，但ＣＳＥＡ组下降程度较大（Ｐ＜０．０５）。结论与ＥＡ相比，ＣＳＥＡ具有麻醉诱导快、范围广、效果好和缩短手术时间等优点，但应注意低血压的防治。
Objective To study the value of combined spinalepidural anesthesia(CSEA) for Caesarean section in comparision with epidural anesthesia(EA).Method Forty healthy paturients with term were randomly divided into a CSEA (n=20) and an EA (n=20) group and all of them received a puncture in the L2～3 interspace by middle approach. In CSEA group, a 26gauge spinal needle was introduced through a back eye Tuohy needle.Result ①The quality of surgical analgesia in CSEA group was better than that in EA group except for two paturients with failed spinal anesthesia. ② In comparision with EA group,the dose of local anesthetic was much smaller(P<[WT5”BZ]0.01) while the cephalad speed of block after induction was much higher in CSEA group. ③The time interval from neonate delivery to the end of operation was similar in both, but the time from induction to skin incision and from skin incision to delivery was shorter in CSEA group.(P<0.01).④Hypotension (SBP<13.3kPa) occurred in both groups with a similar frequency but developed more serious (P<0.05) in CSEA group.Conclusion In comparison, CSEA has the advantage of rapid induction ,extensive analgesia spread, good anesthesia quality and short operative time,but the hypotension must be prevented and treated effectively.
出处
《潍坊医学院学报》
1998年第2期113-114,共2页
Acta Academiae Medicinae Weifang
关键词
硬膜外麻醉
脊椎麻醉
剖腹产
应用
epidural anesthesia
spinal anesthesia
caesarean section
