硬膜外腔注入不同容量生理盐水对腰麻硬膜外联合麻醉平面的影响

Effect of different physiological saline volume administering to epidural space on the anesthetic level of combined spinal-epidural anesthesia

目的了解腰麻硬膜外联合麻醉(CESA)中硬膜外腔注液对麻醉平面的影响。方法CESA120例随机分为A、B两组,每组60例,A组分为A1、A2、A3,B组分为B1、B2、B3。腰麻平面固定后,A组为平卧位,B组为头高脚低位10°～15°,A1、B1组经硬膜外腔注入生理盐水5ml,A2、B2组经硬膜外腔注入生理盐水10ml,A3、B3组经硬膜外腔注入生理盐水20ml。结果注液后10min,A1、B1组平面基本无变化;A2、A3组阻滞平面升高分别为(2.02±0.54)、(2.01±0.69)个脊神经节段(P<0.05)。B2、B3组平面升高分别为(0.47±0.17)、(0.50±0.35)个脊神经节段(P>0.05)。A2、A3组与B2、B3组之间相比差异有显著意义(P<0.01)。结论CSEA中硬膜外腔注液可升高麻醉平面,平卧位注液较头高位注液平面升高更为明显,注入不同容量的生理盐水对麻醉平面有直接影响。

Objective To observe and discuss the effect of different volume administering to epidural space on the anesthetic level of combined spinal-epidural anesthesia(CESA).Methods One hundred and twenty patients undergoing CESA were randomly divided into two groups of sixty patients each:lying prostrate group as A group;And head running up 10～15 degree group as B group.According to the different physiological saline volume administering to epidural space,each group were divided into three subgroups,A1,B1 were administered to epidural space 5ml,A2,B2 were administered to epidural space 10ml,A3,B3 were administered to epidural space 20ml.Results After administering 10 minutes,the anesthetic levels of A1,B1 almost not changed.In A2,A3,the level ascended (2.02±0.54),(2.01±1.69) spinal cord section(P<0.05) respectively.In B2,B3,the level ascended (0.47±017),(0.50±0.35) spinal cord section(P>0.05).The difference between A2,A3 and B2,B3 was significant(P<0.01).Conclusion Administering to epidural space with liquid can increase the anesthetic level during CSEA,especially in llying prostrate group than that in head running up 10～15 degree group.The volume of physiological saline administering to epidural space have direct influence on the anesthetic levels.