不同间隙腰硬联合麻醉在妇产科手术中的应用效果比较

Effect of Combined Spinal Epidural Anesthesia with Different Space in Obstetrics and Gynecology Surgery

目的:比较不同间隙腰硬联合麻醉在妇产科手术中的应用效果。方法:选取2016年6月-2018年6月本院收治的100例妇产科手术患者,均接受腰硬联合麻醉。根据不同麻醉间隙将其分成A组(n=50)和B组(n=50)。A组于L2～3间隙行穿刺麻醉,B组于L3～4间隙行穿刺麻醉,比较两组麻醉效果、麻醉恢复及不良反应发生情况。结果:A组麻醉优良率为96.00%,高于B组的82.00%,比较差异有统计学意义(P<0.05);A组术后苏醒时间、拔管时间分别为(12.25±4.73)、(20.13±4.62)min,均短于B组的(15.86±4.58)、(32.57±4.07)min,比较差异均有统计学意义(P<0.05),但两组麻醉后恢复室停留时间比较差异无统计学意义(P>0.05);A组不良反应发生率为6.00%,低于B组的24.00%,比较差异有统计学意义(P<0.05)。结论:L2～3间隙与L3～4间隙行腰硬联合麻醉方式相比较,前者能够有效提高麻醉效果,降低不良反应发生率,缩短患者术后意识恢复时间,因此在妇产科手术中首推L2～3间隙腰硬联合麻醉。

Objective：To compare the effect of combined spinal epidural anesthesia with different spacein obstetrics and gynecology surgery.Method：A total of 100 patients with obstetrics and gynecology surgery from June 2016 to June 2018 in our hospital were selected,they were treated with combined spinal epidural anesthesia.According to different anesthesia spaces,they were divided into A group（n=50） and B group（n=50）.A group underwent puncture anesthesia at L2-3 space.B group underwent puncture anesthesia at L3-4 space.The anesthetic effect,anesthetic recovery and adverse reactions between two groups were compared.Result：The excellent and good rate of anesthesia in A group was 96.00%,which was higher than 82.00% in B group,the difference was statistically significant（P〈0.05）.The recovery time and extubation time of A group were（12.25±4.73） and（20.13±4.62） min respectively,which were shorter than（ 15.86±4.58） and（ 32.57±4.07）min in B group,the differences were statistically significant（P〈0.05）.But the anesthesia recovery room stay time in two groups was compared,the difference was not statistically significant（P〉0.05）.The incidence of adverse reactions in A group was 6.00%,which was lower than 24.00% in B group,the difference was statistically significant（P〈0.05）Conclusion：Compared with the combined spinal epidural anesthesia in L2-3 space and L3-4 space,the combined spinal epidural anesthesia in L2-3 space can effectively improve the anesthetic effect,reduce the incidence of adverse reactions and shorten the recovery time of postoperative consciousness.Therefore,the combined spinalepidural anesthesia in L2-3 space is the first choice in gynecological and obstetric surgery.