加强型聚脲胺酯钢丝硬膜外导管对剖宫产术麻醉效果的评价

Effects evaluation on wire polyurethane epidural tube used to epidural anesthesia for cesarean section

目的在剖宫产手术中，比较加强型聚脲胺酯钢丝硬外导管与聚氯乙烯硬膜外导管对硬膜外阻滞麻醉效果的影响。方法200例拟行剖宫产手术产妇，采用连续硬膜外阻滞麻醉，随机分为聚氯乙烯硬膜外导管组（A组，n=100）和加强型聚脲胺酯钢丝硬膜外导管组（B组，n=100），以阻力消失作为判断硬膜外穿刺针顺利到达硬膜外腔的标志，记录放置硬膜外导管时遇到的阻力、触电感发生情况及阻滞平面达R的局麻药剂量，并评价麻醉效果。结果两组产妇人口学特征及手术时间等比较差异无统计学意义（P〉0．05），A组和B组未遇到明显阻力分别为47．0％和91．0％，遇到轻微阻力分别为40．0％和8．0％；遇到阻力较大，放入导管困难分别为13．0％和1．0％，组间比较差异有统计学意义（P〈0．01）。A组触电感发生率为10．0％，B组触电感发生率为1．0％，组间比较差异有统计学意义（P〈0．01）；所需罗哌卡因剂量A组（133．0±26．0）mg、B组（121．0±7．0）mg，组间比较差异有统计学意义（P〈0．05）；麻醉效果评分A组（1．45±0．43）分、B组为（0．47±0．14）分，两组比较差异有统计学意义（P〈0．05）。结论加强型聚脲胺酯钢丝硬膜外导管应用于剖宫产手术硬膜外腔麻醉中，硬外置管顺利，可明显改善麻醉效果。

Objective To compare the influence of wire polyurethane epidural tube with polyvinyl chloride epidural tube on the spinal anesthesia effect in cesarean section. Methods 200 pregnant women for elective cesarean section under epidural anesthesia were selected and randomly divided into two groups：polyvinyl chloride tube group （group A, n=100） and wire polyurethane epidural tube group （group B, n=100）, the effects were judged by the epidural puncture needle getting to the epidural space without any resistance. In this process,the resistance to insertion of epidural tube, the incidence of electric shock and anesthesia dose on the block level were recorded, then we compared and evaluate the efficacy of the anesthesia. Results Demographic characteristics and time of operation of two groups had no statistical significance （/9 〉 0.05）. No resistance to insertion of epidural tube occurred in group A （47.0%） and 91.0% in group B of patients; Slight resistance was 40.0% in group A and 8.0% in group B; mild resistance and difficulty to insertion of epidural tube was encountered 13.0% and 1.0% of patients in group A and group B respectively. They were all significantly different （P 〈 0.01）. The incidence of electrical sensation was 10.0% and 1.0% in group B, the difference had statistical significance （P 〈 0.01）. The patients in group A who needed ropivacaine dose of （133.0 ± 26.0）mg, group B was （121.0 ± 7.0） rag, the difference had statistical significance （P 〈 0.05）.Anesthesia effect score in group A was （1.45 ±0.43）, that of group B was （0.47 ±0.14）, the difference had statistical significance （P 〈 0.05）. Conclusion Wire polyurethane epidural tube applied to spinal anesthesia in cesarean section has distinct effect than others, when it＇ s placed in epidural space more smoothly.