摘要
目的观察硬膜外麻醉改良操作的效果。方法将558例患者随机分为3组,每组又分为A、B2个亚组:(1)Ⅰ组:ⅠA组在开通静脉通道后,硬膜外腔穿刺前就给"静痛合剂"量的1/3,待消毒时再给余下2/3,余不变;ⅠB组在消毒时才给"静痛合剂",静脉推注1次加入。评价术中镇静安定程度。(2)Ⅱ组:ⅡA组为硬膜外穿刺成功后置硬膜外管前先入5ml为试验量,ⅡB组硬膜外腔穿刺成功即置硬膜外管,待平卧位时才开始给试验量5ml。评价从平卧到可开始手术时间和平卧后15min时术区患者的疼痛情况。(3)Ⅲ组:ⅢA既分次静脉注射"静痛合剂",又硬膜外穿刺成功后,先注入试验剂量再置硬膜外管;ⅢB组为常规操作,置好管仰卧时开始给药,消毒时开始给"静痛合剂",评价Ⅰ组和Ⅱ组是否有相加效应。结果3组各亚组之间的差异均有统计学意义(P均<0.05)。结论分次静脉注射"静痛合剂",硬膜外穿刺成功后,先注入试验剂量再置硬膜外管,结果患者镇静安定情况较对照组好,可开始手术的时间要短(提前开始手术),一定时间内术区疼痛较常规操作少。
Objective To observed the effect of operation of epidural anesthesia to be improved. Methods 558 cases of patients were randomly divided into 3 groups, each further divided into two sub-groups of A and B ： （ 1 ） Ⅰ group ： When the vein channels to be opened of the I A group administered the ＂quiet pain mixture＂ of 1/3 before epidural puncture,while disinfecting gaven the rest 2/3 ,remain unchanged. About group ⅠB administered ＂quiet pain mixture＂ when the sterilization ,by adding a intravenous push. Evaluated the degree of calm and stability of intraoperative. （2） Ⅱ group： After the success of epidural puncture, group Ⅱ A gave the test volume of 5ml before the epidural catheter,When the success of epidural puncture to place epidural catheter of IIB group until supine to the test volume of 5ml. Evaluated the pain status in ,operation area of patients at the time from lying to beginning the operation and fifteen minutes after lying down. （3） Ⅲ group： Group Ⅲ A both gave intravenous drip ＂quiet pain mixture＂ fractionation and after epidural puncture succeed,injected test dose and then setted epidural catheter. Group ⅢB were treated with conventional operations, when lying down began to administer drugs after indwelled catheter,and gave the ＂quiet and pain mixture＂ while disinfection, Group Ⅰ and Ⅱ whether had the additive effect to be evaluated. Results The differences between subgroups of these three groups were statistically significant （ P 〈 0.05 ）. Conclusion Graded intravenous ＂static mixture pain＂, the success of epidural puncture, the first dose and then into the test tube membrane outer tube, the results of patients with stable and calm the situation were worse than the control group, and may be the beginning of a short operation time （the beginning of the operation in advance）, a certain period of time than conventional surgery pain less operation.
出处
《临床合理用药杂志》
2009年第19期35-36,共2页
Chinese Journal of Clinical Rational Drug Use
关键词
麻醉
硬膜外
置管
镇静
镇痛
Anesthesia
Epidural
Indwelling catheter
Sedation
Analgecize
