腰麻联合硬膜外阻滞行全子宫切除术与单纯硬膜外麻醉的比较

Comparison between combined spinal-epidural anesthesia and continuous epidural anesthesia in complete hysterectomy

目的 :比较腰麻联合硬膜外阻滞与单纯硬膜外麻醉在全子宫切除术中的麻醉效果、并发症发生率和血流动力学的影响。方法 :选择择期全子宫切除手术患者 80例。随机分为CSEA组 (腰麻联合硬膜外阻滞 ) 4 0例 ,CEA组 (单纯连续硬膜外麻醉 ) 4 0例。结果 :与CEA组比较 ,CSEA组麻醉显效时间快 ,麻醉平面达T6时间和最高平面时间短 ,局麻药用量少 ,而且镇痛好、肌松佳 ,两组比较有显著性差异 (P <0 0 5或P <0 0 1 )。术中低血压、恶心、呕吐、寒战发生率两组无差异 ,两组术后腰背痛、头痛发生率等合并症无统计学差异。结论 :CSEA为临床全子宫切除手术提供了一种作用迅速 ,阻滞完善 ,局麻药用量小 ,并发症发生率低。

Objective:To valuate the efficacy and the incidence of complication and homodynamic changes in the combined spinal epidural anesthesia(CSEA) and continuous epidural anesthesia(CEA) in complete hysterectomy.Methods:Eighty patients scheduled to undergo complete hysterectomy were randomly assigned to two groups:forty patients received CSEA(CSEA group) and forty patients received CEA(CEA group).Results:Compared with the CEA group,CSEA group had following advantages:earlier onset times of anesthesia,the shorter time of anesthesia level to T 6 and maximum level,smaller dose of local anesthesia,better effect of analgesic pain and more intensive motor block(P<0 05 or P<0 01).There was difference between the two groups in the incidence of hypotension,nausea,vomiting,chill,postoperation backache and headache.Conclusion:CESA provides a better anesthesia way for complete hysterectomy.