腰麻联合硬膜外麻醉用于子宫切除术的临床观察

Clinical Effects Comparison of Combined Spinal-epidural Anesthesia for Hysterectomy

目的探讨腰麻联合硬膜外麻醉用于子宫切除术临床效果。方法选取我院2011年3月—2013年1月收治行子宫切除术患者160例,采用随机数字表法分为对照组和观察组,每组各80例;其中对照组患者采用单纯硬膜外麻醉;观察组患者采用腰麻联合硬膜外麻醉;比较两组患者镇痛优良率,肌肉松弛优良率,麻醉前后生命体征变化情况,利多卡因用量,有效阻滞时间及不良反应发生率等。结果观察组患者肌肉松弛优良率明显优于对照组,组间比较差异显著(P<0.05);观察组患者镇痛优良率明显优于对照组,组间比较差异显著(P<0.05);两组患者麻醉后收缩压指标组间比较差异显著(P<0.05);观察组患者利多卡因用量及有效阻滞时间均明显优于对照组,组间比较差异显著(P<0.05);同时观察组患者不良反应率明显低于对照组,组间比较差异显著(P<0.05)。结论与单纯硬膜外麻醉相比,腰麻联合硬膜外麻醉用于子宫切除术可有效提高肌肉松弛及镇痛效果,稳定生命体征,减少不良反应发生风险,具有临床使用价值。

Objective To investigate the therapeutic effect of combined spinal-epidural anesthesia for hysterectomy. Methods 160 patients with hysterectomy were chose in the period from March 2011 to January 2013 in our hospital and randomly divided into two groups including control group （80 patients） with continuous epidural anesthesia and observation group （80 patients） with combined spinal-epidural anesthesia; and the good and excellent rate of analgesic, the good and excellent rate of muscle relaxants, changes in vital signs before and after anesthesia, lidocaine dosage, effective blockade time and the incidence of adverse reactions of both groups were compared. Results The good and excellent rate of analgesic of observation group were significantly better than control group （P〈0.05）. The good and excellent rate of muscle relaxants of observation group were significantly better than control group （P〈0.05）. There was significant differences in systolic blood pressure after anesthesia between control group and observation group; The lidocaine dosage and effective blockade time of observation group were significantly better than control group（P〈0.05）. And the incidence of adverse reactions of observation group were significantly lower than control group （P〈0.05）. Conclusion Compared with continuous epidural anesthesia, combined spinal-epidural anesthesia for hysterectomy can efficiently improve the effects of analgesic and muscle relaxants, stable vital signs, reduce the risk of adverse reactions, and is worthy of clinical application value.