硬膜外麻醉改良操作在阑尾切除术中的效果观察

Observe the Effect of Operation of Epidural Anesthesia to be Improved in Appendectomy

目的观察硬膜外麻醉改良操作的效果。方法随机将100例ASA评估Ⅰ-Ⅱ级急性阑尾炎患者分为观察组和对照组,穿刺点位T12~L1间隙。观察组为硬膜外穿刺成功后立即推注5mL 2%利多卡因,然后置入硬膜外导管平卧。对照组为常规操作即硬膜外穿刺成功后置入导管平卧后再推注5mL2%利多卡因试验量。记录两组麻醉的起效时间、到达T6无痛平面时间,药物使用量及患者术中镇痛效果（VAS评分）及术毕阻滞平面范围。结果两组在起效时间、到达T6无痛平面时间及术毕阻滞平面范围存在统计学差异,在药物使用量及术中镇痛效果无明显区别。结论硬膜外穿刺成功后先注入试验量再置管,在不增加麻药用量的情况下可明显缩短开始手术的时间及扩大阻滞平面的范围,且术中镇痛效果较对照组无明显差异。

Objective To observed the effect of operation of epidural anesthesia to be improved.Methods 100 patients with acute appendicitis（ASAⅠ-Ⅱ） were randomly divided into two groups with fifty cases each： observation group and control group.After the success of epidural puncture,the patients in observation group were injected epidurally the test volume of 5mL 2% lidocaine before placing the epidural catheter.After the success of epidural puncture to place epidural catheter,the patients in control group were gave the test volume of 5mL until supine.Onset time of anesthesia,time of reaching the level of T6 block,the volume of 2% lidocaine,range of block after operation and VAS marking were observed and recorded.Results There was no significant difference among the two groups in the volume of 2% lidocaine and VAS marking（P0.05）,the onset time and the time of reaching the level of T6 block were shorter in the observation group（P0.05）.Conclusions After the success of epidural puncture,injecting epidurally the test bolume of 5mL 2% lidocaine before placing the epidural catheter can shorten the onset time of anesthesia and the time of reaching the level of T6 block,so can shorten the beginning time of the operation.