硬膜外导管调整对子宫切除术患者麻醉效果的影响  

Effect of Epidural Catheter Regulating on the Efficacy of Epidural Anesthesia for Hysterectomy

作　　者：许先成[1] 熊良志[1] 王燕[1] 秦成名[1] 

机构地区：[1]湖北医药学院附属太和医院麻醉科,十堰442000

出　　处：《中国医药导刊》2011年第3期391-392,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:观察硬膜外导管调整对子宫切除术患者麻醉效果的影响。方法:将90例择期行子宫切除术患者随机分为实验组和对照组,每组45例,于L_(2-3)间隙行硬膜外穿刺,头向置管4cm。对照组直接固定,实验组按照满足"从导管注入2ml空气无阻力,且可立即回抽回约等量气体"两项条件的不同情况评价导管通畅度,如不通畅则调整导管,将导营逐次拔出1cm后(至少保留2cm)重新评价,使导管尽量通畅后固定。两组均硬膜外给予2%利多卡因5ml,5min后注入混合液14ml。观察患者感觉和运动阻滞效应及麻醉效果。结果:两组间感觉阻滞达最高平面所需时间,差异无统计学意义(P>0.05)。两组间感觉、运动阻滞起效时间,感觉阻滞所达最高平面、运动阻滞程度、腹部肌肉松弛程度及麻醉效果,差异有统计学意义(P<0.05)。结论:硬膜外导管调整可改善麻醉效果。objective：To investigate the effect of epidural catheter regulating on the efficacy of epidural anesthesia for hysterectomy. Methods：Ninety ASA I or II female patients were randomly divided equally into two groups.The catheter was fixed directly in control group when epidural anesthesia was performed at L2-3 interspace and the catheter was advanced 4cm into the epidural space in cephalic direction.In experimental group,the unblocked degree of epidural catheter was evaluated according to the standard that we could infuse 2ml air into epidural cavity from catheter easily and then pump back about the same volume gas immediately,the catheter was extracted Icm or 2cm to let the catheter as unblocked as possible if obstructed.Correct epidural catheter placement was confirmed with 2% lidocaine 5ml,epidural anesthesia was produce with mixed local anesthetic 14 ml.The effect of sensory and motor block and anesthetic efficacy were recorded.Rusults：The time needed to reach the highest level of sensory block in two groups has no dilTerence（P〉0.05）.The onset time of sensory and motor block,the highest level of sensory block,the degree of motor block and abdominal muscle relaxation,and anesthetic efficacy has significant difference between two groups（P〈0.05）.Conclusinn：The epidural catheter regulating could improve the efficacy of epidural anesthesia.

关 键 词：硬膜外导管 麻醉 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]