腰硬膜外联合麻醉和持续硬膜外麻醉用于二次剖宫产术效果的比较  

Comparison of spinal-epidural anesthesia and epidural anesthesia in second caesarean section

作　　者：周洪贵[1] 李佳平[1] 黄锦[1] 陈斌[2] 

机构地区：[1]川北医学院附属医院妇产科,四川南充637000 [2]川北医学院附属医院麻醉科,四川南充637000

出　　处：《重庆医学》2010年第1期64-65,68,共3页Chongqing medicine

摘　　要：目的比较腰硬膜外联合麻醉(CSEA)和持续硬膜外麻醉(CEA)在二次剖宫产手术中的效果。方法选择70例择期二次剖宫产孕妇,随机分为腰硬膜外联合麻醉组(36例)和持续硬膜外麻醉组(34例),观察两种方法的麻醉效果、合并症、对孕妇血流动力学和对新生儿的影响,手术者对麻醉方法和产妇术后镇痛的评价。结果腰硬膜外联合麻醉组与持续硬膜外麻醉组比较具有用药量少、起效时间快、镇痛完善和腹部肌肉松弛好等优点,手术者对麻醉效果和产妇对术后镇痛都满意。结论腰硬膜外联合麻醉具有持续硬膜外麻醉和腰麻的双重优点,对于二次剖宫产手术仍能达到很满意的麻醉效果,明显优于持续硬膜外麻醉。Objective To study the effect of combined spinal-epidural anesthesia and epidural anesthesia applied to the patients underwent the second caesarean section. Methods 70 patients who underwent the second caesarean section were randomly designed to receive combined spinal-epidural anesthesia（36 cases） and epidural anesthesia（34 cases）. We observed the anaesthetic effects, complications,influence to maternal bemodynarnics and neonates together with the assessment for both anaesthetic quality made by operator and postoperative analgesia made by patients of two different anesthesia methods. Results Compared with epidural anes- thesio combined spinal-epidural anesthesia had the advantages of lower drug consumption, faster effect,consummate analgesia and better abdominal muscle relaxation. Both operators and patients were satisfied with it. Conclusion Combined spinal-epidural anes- thesia has the merit of both epidural anesthesia and lumbar anesthesia. For the patients undergoing second caesarean section,an approving anaesthetic effect can also be achieved by combined spinal epidural anesthesia, which is obviously betler than epidural anesthesia.

关 键 词：腰硬膜外联合麻醉 持续硬膜外麻醉 二次剖宫产 

分 类 号：R719.8[医药卫生—妇产科学] R614.42[医药卫生—临床医学]