腰麻后即刻硬膜外腔注入生理盐水预防剖宫产术后头痛

Prevention of post-lumber puncture headache after cesarean section by injecting normal saline into epidural space immediately after spinal anesthesia

目的:探讨腰麻后即刻硬膜外腔注入生理盐水预防剖宫产术后头痛的临床效果。方法:选择正常足月孕妇150例,设立对照组(C组)和试验组,其中试验组又分为生理盐水5ml组(A组),生理盐水10ml组(B组)。选择L3～4间隙穿刺,进入蛛网膜下腔且见脑脊液流出后注入10%葡萄糖1ml+0.75%布比卡因1.5ml。对照组注毕腰麻药物后拔出穿刺针,试验组注毕腰麻药后退出穿刺针约0.5cm直至无脑脊液流出后注入生理盐水5ml(A组)和10ml(B组),术后住院期间每天访视并记录产妇是否出现头痛。结果:对照组有12例出现头痛,发生率为24%;5ml试验组术后头痛4例,发生率为8%;10ml试验组术后头痛2例,发生率为4%。结论:腰麻后即刻硬膜外腔注入生理盐水能够有效预防剖宫产术后头痛,该方法简便、易行、安全。

Objective：To investigate the clinic effect for preventing post-lumber puncture headache after cesarean section by injecting normal saline into epidural space immediately after spinal anesthesia. Methods：One hundred and fifty ASA I patients with fulhime pregnancies age ranged from 22-35 years and body weight from 50-90 kg undergoing cesarean section were studied and divided into three groups of 50 patients： group A,B and C. Group A was injected normal saline 5 ml into epidural space immediately after spinal anesthesia and Group B was injected normal saline 10 ml. Group C wasn＇t injected normal saline into epidural space after spinal anesthesia .Headache was recorded and compared among the 3 groups during admission. Results：There was 12 headache cases in group C, 4 eases in group B and 2 eases in group A. Occurrence frequency was 24%,8%and 4% respectively. Headache occurrence frequency in group C was significantly higher than that in group A,B. Conclusion：By injecting normal saline into epidural space immediatly after spinal anesthesia can prevent post-lumber puncture headache effectively. This method is safe and simple.