颈部硬膜外麻醉的应用  

A Retrospective Analysis of Continuous Cervical Epidural Block

作　　者：郭向阳[1] 于瑞英[2,1] 任洪智[2,1] 叶铁虎[2,1] 罗爱伦[2,1] 

机构地区：[1]中国协和医科大学协和医院 [2]中国医学科学院

出　　处：《中国医学科学院学报》1993年第6期437-440,共4页Acta Academiae Medicinae Sinicae

摘　　要：本组对近十年763例颈部硬膜外麻醉进行了回顾性调查研究,分析了不同浓度局麻药对呼吸、循环的影响,以及颈部硬膜外麻醉并发症的原因。认为颈部硬膜外麻醉具有对呼吸、循环抑制轻,成功率较高(98.03％),术中患者清醒可配合手术等优点,比较安全可靠。同时强调:(1)颈部硬膜外穿刺置管操作应轻柔,以免损伤脊神经根造成感觉和运动功能障碍;(2)选用低浓度局麻药以达到主要阻断感觉神经为主的目的,术中应加强对呼吸、循环的监护与管理;(3)严格掌握适应症。但如何消除颈部硬膜外麻醉术中的牵拉反应,尚待进一步研究。This article reviews 763 patients who underwent continuous cervical epidural block (CCEB) in our hospital during the past ten years. We analyzed the factors causing complications of CCEB and the respiratory and hemodynamic inhibition caused by different concentrations of local anesthetics. From the study, it is concluded that CCEB has obvious advantages, such as mild respiratory and hemodynamic inhibition, satisfactory analgesia, no air pollution and low cost. On the other hand, CCEB requires highly skilled manipulation during epidural puncture and catheterization, careful intraoperative management and appropriate local anesthetics. The question of how to eliminate the intraoperative traction reaction needs further study.

关 键 词：颈部 硬膜外麻醉 并发症 

分 类 号：R614.42[医药卫生—麻醉学]