应用HANS辅助硬膜外麻醉预防剖宫产内脏牵拉痛的临床研究  

A CLINCAL STUDY ON THE PREVENTION OF VISCERALO VISCERAL TRACTION PAIN DUING CESAREAN SECTION USINS-ASSISTED EPIDURAL ANESTHESIA

作　　者：刘延青[1] 刘文兴[1] 王琼[1] 余铣雄[1] 康妹娟[1] 

机构地区：[1]广州市妇婴医院麻醉科,北京医科大学神经科学研究中心

出　　处：《中国疼痛医学杂志》1996年第4期215-216,共2页Chinese Journal of Pain Medicine

摘　　要：为探讨韩氏穴位神经刺激仪（ＨＡＮＳ）应用于剖宫产麻醉，是否能起到辅助麻醉，预防剖宫产时内脏牵拉痛的作用。随机选择ＡＳＡⅠ缓急症或择期剖宫产产妇４０例，分为两组：Ⅰ组（ＨＡＮＳ组）２０例，ＨＡＮＳ加硬膜外麻醉。Ⅱ组（对照组）２０例，单纯应用硬膜外麻醉。ＨＡＮＳ组将ＨＡＮＳ两对电极分别置于双侧足三里、三阴交穴位。频率１００Ｈｚ，强度为１０～１５ｍＡ等幅刺激。诱导时间为１５～２０分钟，持续３０～７０分钟。术中监测循环指标。ＳｐＯ２及分娩后婴儿Ａｐｇａｒ评分，观察切开腹膜、分离膀胱反折、婴儿分娩、清理宫腔及探查附件时，五个阶段的内脏牵拉痛发生情况。术后随访镇痛效果及维持时间。结果表明：除附件探查时两组内脏牵拉痛发生率无差异外，其余几个阶段对照组牵拉痛发生率均明显高于ＨＡＮＳ组（Ｐ＜０．０１），且ＨＡＮＳ组母婴安全，各项监测指标稳定，无任何不良反应。术中需用麻醉性镇痛药者对照组（３０％）明显多于ＨＡＮＳ组（５％）。但硬膜外局麻药用量两组间无差异，这可能与本组手术时间短有关。术后镇痛时间，ＨＡＮＳ组（平均５．２３ｈ）较对照组（１．１５ｈ）明显延长。结论：ＨＡＮＳ辅助硬膜外麻醉能有效预防剖宫产术中内脏牵拉痛的发生，减少术?The purpose of this study was to observe the clinical effects of using HANS(Han's Acupoint Nerve Stimulator) assisted anesthesia to suppress visceral traction pain dur ing Cesarean section.40 ASA 1 parturients undergoing Cesarean section were randomly divid ed into two groups:groupⅠ(20 cases)was given HANS(Acupoints selected: bilateral Zusanliand Sanyinjiao)combined with epidural anesthesia and groupⅡ(20 cases)was given epidu ral anesthesia only.For HANS stimulation, the frequency used was 100 Hz and the intenci ty was 10-15mA.Visceral traction pain was observed in five periods duing the operation(openning peritoneum;detuching peritoneum between uterus and bladder;fetal delivey;clearing cavity of uterus;exploring adnexa).The results showed that the incidence ofvisceral traction mp in groupⅠwas significantly higher than that in groupⅠ(except forthe period of exploring adnexa).More patients in group, were administered analgesic dur ing operation.The duration of postoperative analgesia in groupⅠ(5.23h)was Significantlylonger than in group 1(1.15h).No Side effects were observed in two groups. Conclution:HANS assisted epiduural anesthesia is safe and very effective in reducing visceral tractionpain duing Cesarean section.This method can be used more extensively in obstetrical anes thesia.

关 键 词：HNAS 针刺辅助麻醉 剖腹产 疼痛 

分 类 号：R719.8[医药卫生—妇产科学] R441.1[医药卫生—临床医学]