脊麻-硬膜外联合麻醉在剖宫产术中的应用体会

THE USE OF COMBINED SPINAL AND EPIDURAL ANESTHESIA IN CESAREAN SECTION

目的 :探讨脊麻 -硬膜外联合麻醉在剖宫产术中的应用。方法 :对 32 0例剖宫产病人应用脊麻 -硬膜外联合麻醉情况进行回顾性分析。结果 :32 0例病人中麻醉优良为 31 6例 ,蛛网膜下腔给药后 1 5 min内麻醉平面固定 ,低血压发生率 2 1 %,蛛网膜下腔注入 0 .5 %布比卡因 1 .2～ 1 .8m L可获得满意的麻醉效果 ,蛛网膜下腔给予吗啡 0 .1 mg可产生 48h以上的镇痛效果 ,术后头痛 4例。结论 :脊麻 -硬膜外联合麻醉具有作用迅速、镇痛好、肌松好、用药量少等优点 ,是一种理想的剖宫产手术麻醉方法。

Objective:To observe the clinical efficacy of combined spinal and epidural anesthesia for cesarean section.Methods:320 cases with combined spinal and epidural anesthesia for cesarean section were analyzed retrospectively.Results:316 cases had excellent effect after combined spinal and epidural anesthesia,and the anesthesia level was stable.The rate of hypotension was 21%.When 0 5% bupivacaine with a dose of 1 2 ml 1 8 ml was injected into subarachnoid space,satisfying result could be gained.When 0 1 mg of morphine was injected into subarachnoid space,the analgesic effect could last for 48 hours.4 cases had headache after operation.Conclusion:With the advantage of lower dose of drug used,combined spinal and epidural anesthesia in cesarean section has rapid effect.It also has satisfying muscle relaxing effect.In a word,combined spinal and epidural anesthesia is an ideal method for cesarean section.