联合椎管内麻醉在子宫切除手术中的应用

Combined spinal-epidural anesthesia in hysterectomy

目的 :观察联合椎管内麻醉在妇科子宫切除术中的应用。方法 :4 0例ASAⅠ～Ⅱ级患者 ,于L2～ 3 间隙 ,在联合椎管内麻醉下行子宫切除手术 ,连续监测平均动脉压 (MAP)、心率 (HR)、氧饱和度 (SpO2 ) ,并记录麻醉前、麻醉后、手术开始和手术结束四个时点的MAP、HR、SpO2 。结果 :麻醉优良率 1 0 0 % ,起效时间 (8.1 5± 2 .2 )min ,各时点的MAP、SpO2 无明显变化 (P >0 .0 5 ) ,但麻醉后各时点HR均明显低于麻醉前 (P <0 .0 1 ) ,其余各时点HR无明显变化 (P >0 .0 5 ) ,术中无恶心、呕吐 ,术后无头痛。结论 :联合椎管内麻醉用药少 ,起效快 ,阻滞完善 ,对循环功能影响小 ,适用于妇科手术。

Objective:To observe the application of combined spinal epidural anesthesia in shysterectomy.Methods:Fourty patiens with Ⅰ to Ⅱ grade of ASA received shysterectomy under combined spinal epidural anesthesia(CSEA),and the mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO 2) were monitored continuously.The changes of MAP,HR,SpO 2 at the points of pre anesthesia,post anesthesia,pre operation and post operation were recorded.Results:The anesthetic effect in all patients was satisfactory.The onset of anesthesia was (8.15±2.2)min.There was no difference in MAP or SpO 2 at the four time points( P >0.05),while HR was significantly different between pre anesthesia and post anesthesia( P <0.01),but at other time points,HR had no significant changes( P >0.05).There was no nausea or vomiting during the operation and no headache occurred after spinal anesthesia.Conclusions:CSEA has the advantages of less administration of local anesthetic,perfect nerve block,and little influence on the circulation system.It fits for shysterectomy.