腰麻后即刻硬膜外腔注入与手术结束时注入生理盐水预防剖宫产术后头痛效果比较  

Comparison the effects of post-lumber puncture headache after cesarean section by injecting normal saline into epidural space immediatly after spinal anesthesia and after operation

作　　者：梁天北 蓝英平 谢植远 骆伟娟 苏菊香 

机构地区：[1]广西壮族自治区龙泉山医院麻醉科,广西柳州545005

出　　处：《中国当代医药》2009年第17期64-65,共2页China Modern Medicine

基　　金：广西卫生厅自筹课题(Z2008018)

摘　　要：目的:探讨腰麻后即刻硬膜外腔注入与手术结束时注入生理盐水预防剖宫产术后头痛的临床效果。方法:选择正常足月孕妇100例,分为腰麻后即刻注入组(A组)和手术结束时注入组(B组),每组各50例。腰麻后即刻注入组(A组)选择L3～4间隙行腰穿,进入蛛网膜下腔且见脑脊液流出后注入10%葡萄糖1ml+0.75%布比卡因1.5ml,退出腰穿针约0.5cm,无脑脊液流出后注入生理盐水10ml。手术结束时注入组(B组),选择L3～4间隙行硬膜外穿刺,成功后经硬膜外穿刺针置入腰穿针,进入蛛网膜下腔且见脑脊液流出后注入10%葡萄糖1ml+0.75%布比卡因1.5ml,退出腰穿针,置入硬膜外导管进入硬膜外腔约3.5cm,手术结束时经硬膜外导管注入生理盐水10ml。术后住院期间每天访视并记录产妇是否出现头痛。结果:A组术后头痛2例,发生率为4%。B组术后头痛3例,发生率为6%。结论:腰麻后即刻硬膜外腔注入与手术结束时注入生理盐水均能够有效预防剖宫产术后头痛。Objective：To investigate the clinic effect of preventing post-lumber puncture headache after cesarean section by injecting normal saline into epidural space immediatly after spinal anesthesia and after operation. Methods：One hundred patients with fulhime pregnancies age ranged from 21 to 36 years and body weight from 50 to 85 kg undergoing cesarean section were studied and divided into two groups of 50 patients： group A and B .In group A was injected normal saline 10 ml into epidural space immediate after spinal anesthesia and in group B was injected normal saline 10 ml by epidural catheter after operation.Headache was recorded and compared between two groups during admission. Results： There was 2 headache cases in group A and 3 cases in group B. Occurrence frequency was 4%,6% respectively.There was no significant difference in headache occurrence frequency between two groups. Conclusion：By injecting normal saline into epidural space immediatly after spinal anesthesia and after operation can prevent post-lumber puncture headache effectively.

关 键 词：腰麻 硬膜外腔 生理盐水 剖宫产术 头痛 

分 类 号：R971.2[医药卫生—药品]