笔尖式25G针单次腰麻在剖宫产手术中的应用

Outcome of Single Spinal Anesthesia by Pencil-tip 25G Needle for Cesarean Section

目的 探讨笔尖式25G针单次腰麻在剖宫产手术中的应用。方法 拟接受剖宫产手术的产妇300例,随机分为两组(n=150):A组孕妇采用25G腰麻针单刺麻醉,B组产妇采用针内针技术行腰-硬联合麻醉。记录两组产妇麻醉前、麻醉后5、10、15、20、25、30 min时的收缩压、舒张压及心率,观察两组产妇的麻醉操作时间、穿刺成功率、镇痛效果、新生儿评分及不良反应发生率。结果 两组产妇不同时点的收缩压、舒张压及心率差异无统计学意义(P>0.05);A组麻醉操作时间明显短于B组(P<0.05);两组穿刺成功率、麻醉平面、镇痛效果及新生儿评分情况之间差异无统计学意义(P>0.05);A组产妇的麻醉后不良反应中腰痛的发生率明显低于B组(P<0.05)。结论 笔尖式25G针单刺麻醉对于行剖宫产手术的产妇具有较好的临床效果,麻醉起效快,镇痛效果较好,无腰痛发生,具有较安全的临床应用价值。

Objective To explore the outcome of single spinal anesthesia by pencil-tip 25 G needle for cesarean section. Methods 300 puerpera to undergo selective cesarean section were randomly divided into two groups（n=150）： the puerpera of group A received single spinal anesthesia by pencil-tip 25 G needle, and the puerpera of group B received combined spinal-epidural anesthesia by needleover catheter. Systolic blood pressure, diastolic blood pressure and heart rate were recorded before anesthesia, at 5, 10, 15, 20, 25, 30 min. Duration of anesthesia operated, success rate of puncture, analgesic effect, Apgar score and incidences of adverse effect were determined. Results There was no statistically significant difference in systolic blood pressure, diastolic blood pressure and heart rate（P〉0.05）. Duration of anesthesia operated of group A was less than that of group B（P〉0.05）. There was no statistically significant difference in success rate of puncture, analgesic effect, Apgar score（P〈0.05）. The incidence of backache included in incidences of adverse effect of group A was lower than that of group B（P〈0.05）. Conclusion Single spinal anesthesia by pencil-tip 25 G needle can provide great clinical outcome for cesarean section with effect-acting fast and analgesic effect great, but without backache occured, and therefore it may be a safe therapeutic procedure.