氯普鲁卡因椎管内麻醉后暂时性神经综合征16例临床特点与护理

Clinical feature and nursing intervention of 16 cases of transient neurologic syndrome after spinal anesthesia with chloroprocaine

目的 探讨氯普鲁卡因椎管内麻醉用于剖宫产术后暂时性神经综合征（transient neurologic syndrome,TNS）的临床特点与护理.方法 观察950例氯普鲁卡因椎管内麻醉剖宫产术后产妇的TNS临床表现、发生率、预后、产妇主观感受及护理情况.结果 16例患者麻醉术后出现TNS,发生率为1.68％.临床表现为腰背疼痛,可向臀部、下肢放射或伴感觉异常,持续1～4天,部分患者需药物对症治疗.所有患者均在1周内痊愈,但多数患者及家属担心有神经后遗症.结论 氯普鲁卡因椎管内麻醉剖宫产术后患者的TNS发生率为1.68％,可在1周内痊愈,但医护人员应做好术后护理工作,消除患者及家属对神经后遗症的焦虑.

Objective To study clinical feature and nursing intervention of transient neurologic syndrome （TNS） after spinal anaesthesia with chloroprocaine in caesarean section.Methods 950 pregnant woman undergoing caesarean section after spinal anesthesia with chloroprocaine were included in the study.Observed incidence,clinical feature,prognosis of TNS,subjective feeling of TNS pregnant woman,and nursing experience.Results There were 16 cases of TNS （1.68%）,defined as the new onset of lower back pain that radiated bilaterally to buttocks and lower limbs or distally.Symptoms usually disappeared within 4 days.Part of patients needed symptomatic treatment drugs.All patients recovered within I week,while most of the patients worried about neurologic sequelae.Conclusions The incidence of TNS was 1.68% after spinal anaesthesia with chloroprocaine in caesarean section,which resolved spontaneously within 1 week.Medical staff should do due diligence during postoperative care period to lessen the anxiety on neurologic sequelae among patients and their family members.