25G腰麻针直接用于腰麻的临床观察

25G spinal needle for spinal anesthesia directly to the clinical observation

目的探讨直接将25G腰麻针用于腰麻的可行性及优越性。方法选择择期拟行下肢或下腹部手术,随机分为3组(n=100),A组:普通22G斜面式穿刺针;B组:硬膜外和腰椎联合麻醉穿刺针;C组则直接用套件中的25G细腰穿针进行腰穿。术毕等麻醉平面消散至T10以下后送回病房。交待平卧24h。术后随访3d1,个月后电话随访,记录麻醉消散时间,有无头痛及腰痛、下肢痛或感觉异常。结果所有患者麻醉效果满意,各组患者腰穿穿刺时间差异有统计学意义,与麻醉医生操作熟练程度有关。术后随访:各组间患者麻醉消退时间无差异;头痛发生率以A组最高,腰痛发生率以B组最高,下肢痛或感觉异常以A组为高,而C组未见发生。结论虽然25G腰麻针单独用于腰椎穿刺的技术操作较困难,但术后无腰痛及无头痛的发生,并发症少,麻醉效果确切,患者满意,值得广泛推广。

Objective To study the 25G spinal needle directly used in spinal anesthesia,and discuss its feasibility and superiority.Methods 300 patients（ASA Ⅰ～Ⅱ）undergoing elective surgery on the lower limbs or lower abdomen were randomly divided into three group.A group： use ordinary 22G inclined plane needle.B group： use the needle of combined spinal and epidural anesthesia.C group： 25G spinal needle.Send patients to patients＇ room when the algesia block level dissipated to T10 after operation.All the patients must in supine position for 24 hours.Postoperative follow-up was 3 days,and telephone follow-up was one month.The duration of analgesia,headache,low back pain,leg pain,and paresthesia were recorded.Results All the groups showed satisfactory anesthesia;these 3 groups showed significant difference when compared with puncture time,it was related to the operator.Postoperative follow-up： the duration of analgesia was no difference among groups;headache,leg pain and paresthesia incidence were highest in group A than others,low back pain incidence were highest in group B than others,and there were no incidence in group C.Conclusion Although the anesthesia puncture is difficult by using 25G spinal needle,there were no incidence of headache and low back pain,it had certain anesthetic effect and fewer complications,so the method is worthy of spreading to application.