预充回流试验预防硬膜外麻醉药物毒性反应及提高阻滞成功率的临床研究

Study of Epidural Space Suffusion Liquid Reflow Test Applied to Preventing Toxic Reaction and Improving Success Rate of Block of Epidural Anesthesia

目的研究预充回流试验法对提高硬膜外阻滞成功率的效果及预防硬膜外麻醉药物毒性反应的作用。方法选择硬膜外麻醉进行手术的患者1 500例,按随机数字表法分为A、B两组。A组1 200例为预充回流试验组,再根据术中预充回流液回流情况分为A1、A2组,A1组为出现回流情况组,A2组49例为未出现回流情况组;B组300例,为对照组。观察麻醉全程回流液性状及记录麻醉效果以及麻醉药毒性反应。结果A1组麻醉后平均动脉压与心率均低于A2组和B组(P均<0.05);而A2组和B组麻醉后平均动脉压、心率比较,差异无统计学意义(P>0.05)。A1组麻醉效果优于A2和B组(P均<0.05),但是A2组和B组麻醉效果比较,差异无统计学意义(P>0.05)。A1组局麻药物毒性反应发生率低于A2组和B组(P<0.05),A2组与B组毒性反应发生率差异无统计学意义(P>0.05)。结论预充回流试验能够提高硬膜外阻滞成功率,同时可降低硬膜外麻醉药物毒性反应。

Objective To study the effect of epidural space suffusion liquid reflow test on improving the success rate of epidural block and preventing toxic reaction of epidural anesthesia. Methods 1 500 patients undergoing epidural anesthesia were divided randomly into group A and group B. 1200 cases in group A as epidural space suffusion liquid reflow test group were divided into group A1（ with the reflow） and group A2（ without the reflow） on the basis of reflow phenomenon,300 cases in group B as control group. The character of reflow liquid,effect of anesthesia and toxic reaction during the anesthesia process were observed. Results After anesthesia,the mean arterial pressure and heart rate in group A1 were better than that in group A2 and group B（ all P 〈 0. 05）,but they showed no significant differences between group A2 and group B（ P 〈 0. 05）. The effect of anesthesia in group A1 was better than that in group A2 or group B（ all P 〈 0. 05）,but there was no significant difference between group A2 and group B（ P 〈 0. 05）. The incidence of toxic reaction in group A1 was lower than that in group A2 or group B（ P 〈 0. 05）,but it showed no significant difference between group A2 and group B（ P 〈 0. 05）. Conclusion Epidural space suffusion liquid reflow test can improve the success rate of epidural block and prevent toxic reaction of epidural anesthesia.