连续腰麻应用于妇科肿瘤手术临床效果观察  

Clinical effective research of continues spinal anesthesia in gynecological tumor operation

作　　者：李宇翔[1] 叶玉萍[1] 

机构地区：[1]广东省佛山市妇幼保健院,528000

出　　处：《广州医药》2008年第4期30-32,共3页Guangzhou Medical Journal

摘　　要：目的探讨连续腰麻在妇科恶性肿瘤手术应用中的有效性。方法90例因妇科恶性肿瘤实施开腹广泛全子宫切除并盆腔淋巴清扫手术的患者，随机分成3组，分别为连续硬膜外组（EA组，n=30）、腰硬联合麻醉组（CSEA组，n=30）、连续腰麻组（CSA组，n=30）。EA组于L1-2硬膜外间隙，分次注入0.5％罗哌卡因共计15ml；CSEA组于L3-4间隙蛛网膜下腔注入0.5％罗哌卡因3ml，术中硬外腔追加0.5％罗哌卡因；CSA组采用Spinocath导管针，于L3-4间隙穿刺，蛛网膜下腔置管2cm，注入0．5％罗哌卡因2ml，视阻滞平面追加0．5％罗哌卡因每次0．5ml。比较3组的阻滞平面、镇痛效果、肌松程度，循环变化及术后并发症等情况。结果以上3组在麻醉阻滞平面、镇痛效果、肌松程度。循环变化情况都有显著差异（P〈0．05）。结论连续腰麻具有起效快、效果确切、肌松效果好、血流动力学稳定等优点，能满足妇科肿瘤根治手术的麻醉要求。Objective To investigate the efficacy of continues spinal anesthesia （CSA） in gynecological tumor operation. Methods Ninety patients suffered from gynecological malignant tumor who scheduled per abdomen extensive hysterecto- my and cavitas pelvis lymph dissection were randomly assigned into three groups. The patients in group EA （ n = 30） received fractional injection of 0. 5% ropivacaine 15 ml totally through epidural space in L1-2 ; in group CSEA （n =30） received injection 0. 5% ropivacaine 3 ml in subarachnoid space through L3-4and injected 0. 5% ropivacaine through epideral space in operation; and those in group CSA received subarachnoid space puncturation in L3-4 by Spinocath catheter needle, put the catheter for 2 cm in subarachnoid space and injected 0. 5% ropivaeaine 2 ml, 0. 5% ropivacaine 0. 5 ml were added everytime according to the block level. The block level, analgesia effect, muscle relaxation, circulation and side effect were compared among three groups. Results There were significant difference in the above observation items among three groups （ P 〈 0.05 ） . Conclusion The quick and actual effect, satisfactory muscle relaxation, steady hemodynamics and et al can be provided in CSA, and it will be the suitable anesthesia method in gynecological tumor operation.

关 键 词：连续腰麻 妇科肿瘤 SPINOCATH导管 

分 类 号：R614[医药卫生—麻醉学]