连续腰麻用于肾移植手术的临床观察  

Continuous spinal anesthesia for renal homotransplantation

作　　者：张晔[1] 张滨[1] 田鸣[1] 李树人[1] 

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《国际外科学杂志》2009年第8期528-530,共3页International Journal of Surgery

摘　　要：目的通过比较在。肾移植手术中应用腰麻一硬膜外联合麻醉和连续腰麻的临床效果，探讨连续腰麻用于此类手术的可行性和安全性。方法选择拟行肾移植手术患者60例，随机分为腰麻一硬膜外联合麻醉组（A组）和连续腰麻组（B组），每组30例。A组经腰麻针注入0．75％罗哌卡因2mL后，向头侧置入硬膜外导管，术中根据麻醉需求经硬膜外导管追加0．75％罗哌卡因10mL；B组，经Spinocath导管于蛛网膜下腔注入0．75％罗哌卡因2mL，术中根据麻醉需求经Spinocath导管追加0．75％罗哌卡因1mL。观察2组麻醉效果及患者术中生命体征的变化。结果A、B组均顺利完成手术；2组术中循环功能指标与麻醉前基础值相比均无显著性差异；术后2组均未发现麻醉相关并发症；B组在麻醉平面控制及麻醉维持方面优于A组。结论在肾移植手术中，应用Spinocath导管行连续腰麻是安全、可行的。Objective To discuss the feasibility and safety of continuous spinal anesthesia （CSA） in renal transplantation througb comparing the effects of combined spinal and epidural anesthesia （CSEA） and CSA renal transplantation. Methods Sixty patients undertaking renal transplantation were divided into two groups randomly. Group A, 30 patients, undertaking operation with CSEA; Group B, 30 patients, undertaking operation with CSA. The patients in group A were injected 2 mL 0.75% ropivacaine, then epidural catheter was inserted, 0.75% ropivacaine 10 mL was administered when needed. The patients in group B were injected 2 mL 0.75% ropivacaine into spinal through Spinocath catheter, and 0.75% ropivacaine lml was administered through Spinocath catheter when needed. We observed the effects of the two anesthesia methods and the changes of the patients＇ vital signs. Results The patients in group A and B all completed the operation smoothly; there were no significant differences in the circulatory function before and during operation; there were no complications related to anesthesia in all the patients; group B was superior to group A in the aspects of the control and maintaining of anesthesia. Conclusion Continuous spinal anesthesia applied to renal transplantation is safe and feasible.

关 键 词：连续腰麻 SPINOCATH导管 罗哌卡因 肾移植 

分 类 号：R614[医药卫生—麻醉学]