硬膜穿破后吸入安氟醚预防头痛的临床观察

Clinical Observation of Prevention Headache after Epidural Puncture and The Hard-membrane Wears Out Inspiration Anflurane

目的：观察硬膜穿破后改用静一吸复合全麻，吸入安氟醚与异氟醚对预防术后头痛的比较。方法：ASAⅠ～Ⅱ级，择期行下腹部、会阴部手术硬膜外穿刺穿破硬膜病人26例，均改为气管插管全身麻醉。按吸入麻醉剂不同随机分成安氟醚（E）组和异氟醚（Ⅰ）组。麻醉诱导均相同：静注咪唑安定0．05mg／kg、芬太尼3Ⅱg／kg、异丙酚3mg／kg、维库溴铵0．1mg／kg，气管插管，接麻醉机。安氟醚（E）组吸入安氟醚维持全麻；异氟醚（Ⅰ）组吸入异氟醚维持全麻。术后随访3d，记录头痛情况。结果：二组病人术后头痛发生率有极显著差异（P〈0．01）。E组头痛发生率明显低于Ⅰ组。结论：硬膜穿破后改用吸入安氟醚作全麻可很好预防术后头痛。

Objective：To observe and compare of epidural puncture and the hard-membrane wears out chang to vein-inspiration compound anaesthesia,inspiration anflurane and isoflurane to prevent the headache. Method： 26 patient ASA Ⅰ-Ⅱ. Epidural puncture and the haed-membrane wears out all chang to Vein-Inspiration compound anesthesia. The average divides into two groups：one inspirates Anflurane （A）and the other inspirates Insflurane（ Ⅰ ）. The anaesthesia induction is same： Midazolam 0.05 mg/kg, Fentanny 3 μg/kg, Proofol 3 mg/kg, Vecuronium 0. 1 mg/kg. Group A insparantion anflurane maintains the general anesthesia. Group Ⅰ inspiration Isoflurane maintains the general anesthesia. All patients are visited three days. Recording the headache situation. Results： The rate of headache has the remarkable difference（P〈0.01）. Group A is lower than group Ⅰ. Conclusion： Epidural puncture and the hard-membrane wears out changes to inspiration Anflurane to maintain the general anesthesia to be possible the good technique to prevention the headache.