硬膜外穿刺针引导至黄韧带行单纯腰麻的临床观察

Observation on single spinal anesthesia with the epidural needle guiding into the yellow ligament

目的探讨将腰硬联合穿刺套件中的硬膜外穿刺针引导至黄韧带行单纯腰麻的可行性及优越性。方法选择我院2010-01～2011-01拟行剖宫产手术的ASAⅠ-Ⅱ级患者200例,分为硬膜外和腰椎联合麻醉穿刺法组(A组,n=100)和将腰硬联合套件中的硬膜外穿刺针引导至黄韧带,单纯行腰麻术组(B组,n=100)。剖宫产术毕后,待麻醉平面消退至T10以下送患者回到病房。术后随访1周,询问麻醉消退时间,有无腰痛,下肢痛或感觉异常等并发症。结果两组病人麻醉消退时间无差异,腰痛发生率、下肢痛或感觉异常发生率B组(0)明显低于A组(7%)。结论硬膜外穿刺针引导至黄韧带行单纯腰麻操作简单且具有可行性,此法值得推广。

Objective To investigate the feasibility and advantages of the spinal anesthesia with the epidural needle guiding into the yellow ligament. Methods A total of 200 patients （ASA Ⅰ - Ⅱ ） undergoing elective cesarean section were divided into two groups. Spinal-epidural anesthesia was given in group A and spinal anesthesia was directly used in group B with spinal epidural needle guiding into the yellow ligament. After follow-up for one week, the anesthesia dissipation time, the low back pain, the leg pain and the paresthesi- a were recorded. Results There was no significant difference in the duration of analgesia between two groups. The incidence of the lumbago, the leg pain and the paresthesia in group B was lower than that in group A （0 vs 7%, P 〈 0.05 ）. Conclusion The spinal anesthesia puncture with the epidural needle guiding into the yellow ligament is simple and feasible, and is worthy of being applied ex- tensively.