腰硬联合麻醉在急诊阑尾切除术中的应用价值

Spinal and epidural anesthesia in emergency appendectomy

目的探讨腰硬联合麻醉（CSEA）在阑尾切除术中的应用价值。方法对60例急诊阑尾切除术病人,随机分为试验组和对照组,试验组采用CSEA,对照组采用单纯硬膜外麻醉（EA）。腰麻药选用0.75%布比卡因重比重液,硬膜外麻醉药选用2%利多卡因,两组麻醉平面T6~8水平。监测并记录ECG、SPO2、Bp,麻醉起效时间和阻滞效果。结果 CSEA最高阻滞平面及达到时间比硬膜外组少,差异有显著性（P〈0.01）,CSEA组麻醉效果明显优于EA组,术中麻黄素的使用两组无显著差异（P〉0.05）,两组均无术后头痛。结论 CSEA综合了脊麻以及硬膜外阻滞的优点,是阑尾切除术一种安全可行的麻醉方法,值得推广应用。

Objective To research the effect of spinal and epidural anesthesia on emergency appendectomy.Method 60 cases of emergency appendectomy patients were randomly divided into experimental and control groups.Experimental group were treated with CSEA and the control group with epidural anesthesia（EA）.ECG,SPO2,Bp,onset time and block effects were recorded.Results The block plane and reached the maximum time of CSEA were less than that of epidural group（P0.01）.There was no postoperative headache.Conclusion CSEA combination of spinal and epidural anesthesia is a safe and feasible method of anesthesia.