硬膜外注入空气量对穿刺后腰背痛发生率的影响

Effect of air amount injected into epidural space on the incidence of waist-back pain after operation

目的观察硬膜外间隙穿刺操作时注入空气量对穿刺后腰背疼痛发生率的影响。方法选择下胸段或腰段硬膜外间隙穿刺患者240例,ASA Ⅰ-Ⅱ级。以判定穿刺试验时注入硬膜外间隙空气量分为2组:注气量<3 ml者为Ⅰ组(对照组),共158例;注气量>3 ml者为Ⅱ组(观察组),共82例。比较2组患者术后腰背疼痛发生率和两组VAS评分中不同程度疼痛构成比。结果Ⅱ组腰背痛发生率明显高于Ⅰ组(P<0．05);两组疼痛程度构成比有明显不同(P<0．05),Ⅱ组多为中等程度疼痛,而Ⅰ组疼痛程度较轻。结论硬膜外穿刺时注入空气量>3 ml时,显著增加穿刺后腰背疼痛的发生率。

Objective To observe the relationship between the amount of air injected into the epidural space and the incidence of the waist-back pain after operation. Methods 240 patients ASA Ⅰ - Ⅱscheduled for epidural anesthesia were divided into two groups ： In group Ⅰ 158 patients, the amount of air injected into epidural was 〈3 ml ; In group Ⅱ 82 patients, the amount of air was 〉3 ml. The incidence of the waist-back pain and visual analogue scale （VAS） were recorded after operation. Results The incidence of the waist-back pain in group Ⅱ was obviously higher than that in group Ⅰ （ P〈0.05 ）. The ratio of pain degree in the two groups was significantly different （P〈0.05）. The majority of VAS was middle in group Ⅱ and mild in group Ⅰ, and had statistical difference between two groups. Conclusion Injecting air more than 3ml into epidural space increases the incidence of the waist-back pain after operation, the amount of air injected epidurally is also a reasen that causes the complications of the waist-back pain.