腰麻联合硬膜外麻醉在子宫切除术中的应用

The effect of CSEA in uterus surgery

目的:观察腰麻联合硬膜外麻醉在子宫手术的麻醉效果和毒副作用。方法:80例择期子宫手术病人随机分为CSEA组和CEA组,各40例。麻醉前预输注300～500ml晶体液并静注咪唑安定0.02mg/kg。CSEA组L3～4点穿刺成功行腰麻见脑脊液注0.75%布比卡因1.5～2ml,15～20秒注完置导管后视平面高低注2%利多卡因至满意;CEA组L1～2点穿刺成功置导管后注2%利多卡因至满意。记录各组麻醉显效时间、阻滞平面、局麻药初量、骶神经阻滞程度、1h内血压变化及麻黄素用量。结果:CSEA组麻醉起效快,局麻药初量小,骶神经阻滞完善,阻滞范围广,麻黄素用量小,低血压和恶心呕吐发生率低。结论:腰麻联合硬膜外麻醉用于子宫手术效果确切,毒副作用也较小。

Objective To investigate the effects of Combined Spinal and Epidural Anesthesia(CSEA) and its side effects. Methods 80 cases of uterus surgery were randomly divided into group of CSEA and group of Continue Epidural Anesthesia(CEA), each group was 40 cases.Before anesthesia all cases were given 300 ～500ml fluid to infused and midazolam(0.02mg/kg)to injected.The group of CSEA were injected bupivacaine(0.75%;1.5～2 ml) at L3～4 After Spinal anesthesia(SA) and 15～20 seconds later were injected lidocaine(2%). The group of CEA were injected lidocaine(2%) at L1～2 after spinal anesthesia(SA).the effectual time,level,primary dose,degree of sacral anesthesia ,the change of blood press in 1 hour and the dose of epherdrine were recorded . Results In the effectual time,level,primary dose,degree of sacral anesthesia , the change of blood press in 1 hour and the dose of epherdrine ,the effect of CSEA is better than CEA . Conclusion There is exact effect of CSEA in uterus surgery .