摘要
研究导管针连续腰麻的临床应用效果。方法 :选择行前列腺电切术的老年病人 6 0例 (年龄 6 0～ 80岁 )ASAⅠ～Ⅱ级 ,随机分成两组 ,每组 30例。Ⅰ组为连续腰麻组 ;Ⅱ组为连续硬膜外组。两组都选择L2～ 3 或L3～ 4做穿刺点。Ⅰ组插入 2 4GSpinocath导管针 ,两组局麻药都为 0 .5 %布比卡因。Ⅰ组负荷剂量为 1.5～2 .5ml,Ⅱ组负荷剂量为 8～ 13ml,手术时间如超过 2h ,再注入 1/3负荷剂量。两组术后都接微量输液泵进行术后镇痛 ,镇痛药液都为 0 .12 5 %布比卡因 +0 .0 0 0 6 %芬太尼 ,Ⅰ组负荷量为 0 .5ml,背景剂量为 0 .5ml/h ,PCA单次注药 0 .5ml,锁定时间为 8min。Ⅱ组负荷量为 2ml,背景剂量为 2ml/h ,PCA剂量为 2ml,锁定时间为15min。两组术后镇痛时间均为术后 5 0h。观察指标为术中阻滞感觉神经时间 ,平面扩散范围 ,运动神经阻滞程度 (改良Bromage评分 ,简称MBS) ,血压及心率下降程度 ,术中辅助用镇痛镇静药情况 ,术后镇痛VAS评分及副反应发生情况。结果 :病人阻滞感觉神经时间Ⅰ组和Ⅱ组比较差异显著 (P <0 .0 1) ;MBS评分Ⅰ组和Ⅱ组比较差异显著 (P <0 .0 1) ;给药后 5minⅠ组和Ⅱ组比较血压下降程度有明显差异 (P <0 .0 5 ) ;Ⅰ组有10 .3%的病人辅助用镇痛药 ,而Ⅱ组有 4 6 .7%的病人辅助用镇痛药 ;?
Objective:To evaluate the clinical effect of over-the-needle continuous spinal anesthesia.Methods:Sixty ASA Ⅰ～Ⅱ patients age over 60 years,scheduled for transurethral prostatectomy,were randomly divided into two groups,groupⅠ:over-the-needle continuous spinal anesthesia(CSA),groupⅡ:continuous epidural anesthesia(CEA).The initial block dose was 1.5～2.5ml of 0.5% bupivacaine(groupⅠ)and 8～13ml of 0.5% bupivacaine (groupⅡ).After the operation,all patients received a intrathecal or epidural analgesia.The patients in groupⅠ received a 0.5ml bolus(bupivacaine 0.125%+fentany10.0006%),followed by a continuous infusion of 25ml over 50 h. The patients in groupⅡ received a 2ml bolus (bupivacaine 0.125%+fentany10.0006%),followed by a continuous infusion of 100ml over 50 h.The anesthesia effect,the degree of motor blockade,the level of pain and the occurrence of side effects were recorded.Results:There were significant differences in onset time,the degree of motor blockade,VAS pain scores and occurrence of side effects.Conclusions:Compared with continuous epidural anesthesia , over-the-needle continuous spinal anesthesia provides perfect anesthesia effects,ensures better analgesia and fewer side effects and results in more satisfied patients.
出处
《中国现代医学杂志》
CAS
CSCD
2002年第15期57-59,共3页
China Journal of Modern Medicine
