腰-硬联合阻滞在骨科下肢急诊手术中的应用观察

Application of Combined Spinal-epidural Anesthesia Technique on the Emergency Operation of Lower Extremities

目的 评价腰-硬联合阻滞(CSEA)在骨科下肢急诊手术的应用效果。方法 ASAⅠ～Ⅱ级60例骨科下肢急诊手术,随机分为CSEA组和硬膜外组,每组30例。比较两组之间的血压、心率、起效时间、阻滞范围、术中VAS评分、下肢运动阻滞程度及肌松效果。结果 CSEA起效时间显著短于硬膜外阻滞,术中VAS评分、下肢运动阻滞、肌松效果显著优于硬膜外组。结论 CSEA应用于骨科下肢急诊手术,具有起效迅速,阻滞效果确切完善,血流动力学平稳,便于术后镇痛等优点。

Objective To study the effects of combined spinal-epidural anesthesia (CSEA) technique on the emergency operation of lower extremities. Methods 60 ASA grade Ⅰ-Ⅱ patients who have emergency operation of lower extremities were randomly divided into CSEA group (n=30) and epidural anesthesia group (n=30). BP、HR、onset time、 block segment、 VAS scores、degree of motor block and muscle relaxation effect were compared. Results onset time of CSEA is much shorter than epidural anesthesia s. VAS scores, degree of motor block and muscle relaxadon effect of CSEA is superior to epidural anesthesia's. Conclusion CSEA have rapid onset, good block effect and stable hemodynamic for emergency lower extremities operations. It is convenient for postoperative analgesia and worthy of popularizing CSEA for lower extremities operations in clinical.