腰麻后即刻硬膜外腔注入生理盐水或右旋糖酐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 or dextran-40 into epidural space immediatly after spinal anesthesia

作　　者：梁天北 蓝英平 谢植远 骆伟娟 苏菊香 

机构地区：[1]广西龙泉山医院麻醉科,广西壮族自治区柳州市545005

出　　处：《临床合理用药杂志》2010年第6期20-21,共2页Chinese Journal of Clinical Rational Drug Use

基　　金：广西卫生厅自筹课题(No:Z2008018)

摘　　要：目的探讨腰麻后即刻硬膜外腔注入生理盐水或右旋糖酐-40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,随机分为A组和B组各50例。2组均选择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,腰穿针退出蛛网膜下腔无脑脊液流出后A组注入生理盐水10ml、B组注入右旋糖酐-4010ml。观察2组术后头痛发生情况,麻醉后生命体征变化情况,比较2组麻醉平面、麻黄碱使用及手术情况。结果A组术后头痛发生率为6%,B组为4%。2组术后头痛发生率、麻醉后生命体征、麻醉平面、麻黄碱使用量、麻黄碱使用率及手术时间、术中出血量、输液量等方面比较差异均无统计学意义(P>0.05)。结论腰麻后即刻硬膜外腔注入生理盐水或右旋糖酐-40均能够有效预防剖宫产术后头痛。Objective To investigate the clinical effect of preventing post-lumber puncture headache after cesarean section by injecting normal saline or dextran-40 into epidural space immediatly after spinal anesthesia.Methods 100 cases of pregnant with fulltime pregnancies were randomly divided into group A and group B,50 cases of each.Group A was injected normal saline 10ml into epidural space immediate after spinal anesthesia and in group B was injected dextran-40 10ml by the same way.Headache was recorded and compared between two groups during admission.Obsered changes in vital signs after anesthesia,compared the two groups of flat anesthesia,ephedrine use and operation situation.Results Headache occurrence frequency of group A was 6%,4% of group B respectively.There was no significant difference in headache occurrence frequency between two groups,and there were no significat differences in changes in vital signs after anesthesia,flat of anesthesia,ephedrine use opration time,blood loss and transfusion volume in operation between the two groups.Conclusion By injecting normal saline or dextran-40 into epidural space immediatly after spinal anesthesia can prevent post-lumber puncture headache effectively.

关 键 词：腰麻 硬膜外腔 生理盐水 右旋糖酐 剖宫产术 头痛 预防 

分 类 号：R614[医药卫生—麻醉学]