25G腰麻针直接用于腰麻的临床观察

A Clinical Observation of 25G Spinal Needle for Spinal Anesthesia Directly

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患者300例,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3d,1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。结果所有病例麻醉效果满意,各组病人腰穿穿刺时间有显著差异,与麻醉医生操作熟练程度有关。术后随访:各组间病人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 25G腰麻针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 investigate the feasibility and advantages of 25G spinal needle directly used in spinal anesthesia.Methods 300 patients（ASA Ⅰ ～ Ⅱ） undergoing elective surgery onthe lower limbs or lower abdomen were randomly divided into three groups.Ordinary 22G inclined plane needle,needle of combined spinal and epidural anesthesia,25G spinal needle were used in A group,B group and C group respectively.After operation,patients were sentto wards when the anesthesia level dissipated to T10 and instructed to be in supine position for 24 hours.During the 3-day postoperative follow-up and telephone follow-up one month later,headache,low back pain,leg pain,and paresthesia were recorded.Results All groupsshowed satisfactory anesthesia.The 3 groups showed significant difference in puncture time,which was related to the anesthesiologists.Postoperative follow-up： there was no difference among groups in the duration of analgesia;headache,leg pain and paresthesia incidence were highest in group A;low back pain incidence was highest in group B,and there was no incidence in group C.Conclusion Although the anesthesia puncture is difficult by using 25G spinalneedle,there were no incidence of headache or low back pain,or complications,so the method is worthy of being applied extensively for its anesthesia effects.