剖宫产行腰硬联合麻醉时硬膜外导管置入长度对导管置入血管并发症的影响

Effects of Length of Epidural Catheter Insertion on Frequency of the Complication of Intravascular Catheter Placement in Patients Undergoing Combined Spinal-epidural Anesthesia for Caesarean Section

目的：观察剖宫产手术行腰硬联合麻醉时硬膜外导管置入长度对导管置入血管并发症的影响。方法：选择在行腰硬联合麻醉时硬膜外导管置管通畅的160例拟接受剖官产手术产妇，年龄（23～36）岁、体重（55～75）kg，随机分成四组，每组40例。160例产妇ASAI级、凝血功能正常、足月妊娠且无妊娠期并发症。腰硬联合麻醉均在L2～3。间隙穿刺，Ⅰ组产妇放置硬膜外导管时置入硬膜外腔内的长度为3cm，Ⅱ组、Ⅲ组和Ⅳ组产妇置入硬膜外腔内的导管长度分别为4cm、5cm和6cm。导管顺畅置入后末端连接注射器回抽观察有无发生导管置入血管的并发症。结果：Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组产妇发生导管置入血管的并发症发生率分别为2．5％、5．0％、5．0％和5．0％，四组中的任意两组之间相互比较差别均无显著性（P＞0．05）。结论：剖宫产手术行腰硬联合麻醉时置入硬膜外腔内的导营长度在3cm、4cm、5cm和6cm时导管置入血管的并发症发生率没有差别。

Objective： To determine effects of length of epidural catheter insertion on frequency of the complication of intravascular epidural catheter placement in patients undergoing combined spinal-epidural anesthesia for caesarean section. Methods： 160 eases of ASA I patients, aged （23～36）yr, weighing （55～75）kg and undergoing combined spinal-epidural anesthesia for caesarean section, were randomized into 4 groups, （40 in each）. All the patients were pregnant at term without any complication of pregnancy and had normal function of blood coagulation. Moreover epidural catheters were all inserted （L2～3） smoothly in the groups during anesthesia, but the length of inserted epidural catheter was 3cm, gem, 5cn and 6cm in the Ⅰ, Ⅱ, Ⅲ and Ⅳ group respectively and the intravascular epidural catheter placement occurred was examined. Results： The frequency of intravascular epidural catheter placement in Ⅰ group, Ⅱ group, Ⅲ group and Ⅳ group was respectively 2.5% ,5.0% ,5.0% and 5.0%. No difference among the four groups （P〉0. 05）. Conclusions： No relationship between the frequencies of the complication of intravascular placement and the length of inserted epidural catheter in epidural space in caesarean section undergoing combined spinal-epidural anesthesia.