脊髓硬膜外联合麻醉在新式剖宫产术中的应用

COMBINED SPINAL AND EPIDURAL ANESTHESIA FOR CESAREAN SECTION

①目的 探讨脊髓硬膜外联合麻醉 (CSEA)在新式剖宫产术中的应用效果。②方法 将 2 0 0例足月健康产妇随机分为CSEA组和连续硬膜外麻醉 (EA)对照组 ,每组 10 0例 ,均以L2～ 3 为穿刺点 ,CSEA组用带有背孔的Tuohy针和 2 5G腰穿针穿刺。③结果 CSEA组麻醉效果明显优于EA组 (u =7.6 6 ,P <0 .0 5 ) ,局麻药用量显著减少 (t=4 .6 2 ,P <0 .0 1) ,手术时间和麻醉诱导时间亦明显缩短 (t=2 .0 5 ,3.82 ,P <0 .0 5 ) ,两组低血压发生率相似 ,但CSEA组血压下降程度较大。④结论 CSEA具有麻醉起效快、用药剂量少、效果好和手术时间短等优点。但应注意低血压的防治。

Objective To observe the efficacy of combined spinal and epidural anesthesia (CSEA)for cesarean section. Methods 200 healthy full term puerpera were randomly divided into two groups: Group One (experimental group, n =100) for CSEA and Group Two(control group, n =100)for continuous epidural anesthesia. The puncture point in both groups was between L 2～3 . A Tuohy needle with back hole and 25G lumbar puncture needle were used for Group One. \ Results\ The effect of anesthesia in Group One was much better than that of Group Two ( u=7.66 ,P <0.05), and much less local anesthetic was used ( t=4.62, P <0.01). The operative duration as well as anesthesia inducement were much shorter ( t=2.05, 3.82, P <0.05). Though the possibility of hypotension was similar in both groups, the blood pressure of Group One dropped greater in extent. \ Conclusion CSEA possesses such advantages as instant action ,smaller dose, better results and shortening of operative duration. However, due attention should be paid to the prevention and management of hypotension.