改进法骶管阻滞麻醉体会

Experience of improve the method in sacral block anaesthesia

目的:比较两种骶管阻滞麻醉穿刺方法的麻醉效果。方法:选择择期行肛门、会阴部和直肠手术的患者120例,ASAⅠ～Ⅱ级,随机分为两组,每组60例。经典法组用经典的骶管阻滞穿刺方法,改进法组用改进的骶管穿刺方法,比较两组在进针深度、改麻醉的例数、穿刺失败的例数、术后尿潴留例数的差别。结果:进针深度上经典法组为2.5～3.5cm,改进法组为0.3～0.5cm(P<0.05);在改麻醉例数上,经典法组为7例,改进法组为0例(P<0.05);在穿刺失败例数上,经典法组为5例,改进法组为0例(P<0.05);在术后尿潴留的例数上,经典法组为6例,改进法组为5例(P>0.05)。结论:在行骶管麻醉时采用改进的穿刺操作方法可以显著提高麻醉的成功率和麻醉的安全性。

Objective： To compare the effect of two kinds of sacral block anaesthesia puncturing method. Methods： 120 patients with elective surgery of anal, perineum and rectum operation were selected, ASAⅠ-Ⅱ, and randomly divided into 2 groups, 60 cases in each group. The classical group was punctured with the classical sacral block, while the improving group with an improved one. Compared with the difference of puncture depth, changing anesthetization cases and puncture failure cases and postoperative urinary retention cases between 2 groups. Results： puncture depth was 2.5-3.5 cm in the classical group, with 0.3-0.5 cm in the improving group （ P0.05）; Changing anesthetization cases was 7 cases in the classical group, with 0 case in the improving group （P0.05）; puncture failure cases was 5 cases in the classical group, with 0 case in the improving group （P0.05）; postoperative urinary retention cases was 6 cases in the classical group, with 5 cases in the improving group （P0.05）. Conclusion： The improving method in sacral block anaesthesia significantly improve the success rate of anesthesia and the safety of the anaesthesia.