摘要
目的观察腰-硬联合麻醉与硬膜外麻醉应用于阴式全子宫切除术的效果。方法选择东莞广济医院2010年1月至2012年8月择期行阴式全子宫切除术的100例患者,采用随机数字表法将其分成两组(n=50):腰-硬联合麻醉(CSEA)组和连续硬膜外麻醉(CEA)组。两组患者均经L2,3间隙行硬膜外穿刺。CSEA组经硬膜外穿刺针行蛛网膜下腔穿刺,注入0.5%盐酸罗哌卡因2.5 mL;CEA组硬膜外注入2%盐酸利多卡因5 mL。两组患者均向尾端置入硬膜外导管3 cm,根据诱导后5 min感觉阻滞平面,硬膜外追加0.75%盐酸罗哌卡因,使阻滞平面达T8水平开始手术。评价两组患者的麻醉效果,记录两组患者麻醉起效时间、阻滞完善时间、硬膜外追加用药量。结果 CSEA组患者麻醉效果评价优于CEA组(P<0.05)。CSEA组患者的麻醉起效时间(2.0±1.6)min,阻滞完善时间(8.3±3.5)min,硬膜外追加用药量(7.1±3.1)mL;CEA组麻醉起效时间(5.2±2.2)min,阻滞完善时间(17.3±4.2)min,硬膜外追加用药量(16.4±5.6)mL,两组间各观察值的差异均有统计学意义(P<0.05)。结论与连续硬膜外麻醉相比,腰-硬联合麻醉的起效时间短,镇痛完全,肌松效果满意,麻醉效果好。
ObjectiveTo observe the effect of combined spinal-epidural anesthesia and continual epidural anesthesia on vaginal hysterectomy.MethodsA total of 100 cases of those who received vaginal hysterectomy at Dongguan Guangji Hospital,from Jan.2010 to Aug.2012 were selected,and randomized into two groups（n=50）：combined spinal-epidural anesthesia（CSEA） group and continual epidural anesthesia（CEA） group.Two groups of patients were performed L2,3 epidural space puncture.CSEA group was then given intrathecal epidural puncture injection of 2.5 mL 0.5% ropivacaine; CEA group was given epidural injection of 5 mL 2% lidocaine hydrochloride.All patients were inserted 3 cm epidural catheter to the end,according to sensory block level after 5 min induction,0.75% epidural ropivacaine hydrochloride was added to reach T8 level block to start surgery.Anesthesia effect of the two groups was evaluated,anesthesia onset time,block complete time,additional epidural dosage were recorded.ResultsThe effect of anesthesia in CSEA group was superior to CEA group（P〈0.05）.CSEA group＇s anesthesia onset time（2.0±1.6） min,block complete time （8.3±3.5） min,epidural exposure added dosage （7.1±3.1） mL,CEA group＇s anesthesia onset time（5.2±2.2） min;block complete time （17.3±4.2） min; epidural exposure added dosage（16.4±5.6） mL.There were significant differences between the two groups（P〈0.05）.ConclusionCompared with CEA,CSEA＇s onset time is short,anesthesia blockage is complete,with satisfying muscle relaxation effect and good anesthesia effect.
出处
《医学综述》
2014年第4期756-757,共2页
Medical Recapitulate
关键词
阴式全子宫切除术
腰-硬联合麻醉
连续硬膜外麻醉
Vaginal hysterectomy
Combined spinal epidural anesthesia
Continual epidural anesthesia
