腰麻联合硬膜外麻醉时硬膜外注药升高阻滞平面的机制与效果分析  

Analysis on the mechanism and effect of epidural injection in elevating block plan during spinal anesthesia combined with epidural anesthesia

作　　者：周利 杜娜娜 徐国勇 

机构地区：[1]武警浙江总队嘉兴医院麻醉科,浙江嘉兴314000

出　　处：《中国现代医生》2017年第29期95-97,104,共4页China Modern Doctor

基　　金：浙江省嘉兴市科技计划项目(2017BY18047)

摘　　要：目的探讨腰麻联合硬膜外麻醉时硬膜外注药升高阻滞平面的机制及应用效果。方法选取我院2016年2月~2017年4月收治的需接受下肢手术患者105例,随机分为研究组和对照组。对照组接受常规硬膜外麻醉方法,研究组在对照组的基础上联合腰麻方法,对比两组患者疾病恢复情况,分析腰麻联合硬膜外麻醉时硬膜外注药升高阻滞平面的机制。结果研究组患者的麻醉所用时间、下床活动所需时间明显短于对照组,差异有统计学意义(P<0.05),研究组患者的麻醉药物用量明显少于对照组,差异有统计学意义(P<0.05),研究组患者阻滞平面范围明显大于对照组,差异有统计学意义(P<0.05)。结论采用腰麻联合硬膜外麻醉的麻醉方法能够明显缩短疾病的治疗时间,有效减少药物所用量且使得阻滞平面得到有效提升,干预效果理想,值得临床上广泛推荐使用。Objective To explore the mechanism and application effect of epidural injection in elevating the block plane during spinal anesthesia combined with epidural anesthesia. Methods 105 patients in need of lower limb surgery who were admitted to our hospital from February 2016 to April 2017 were selected. They were randomly divided into study group and control group. The control group was given conventional epidural anesthesia, and the study group was given combined spinal anesthesia on the basis of the control group. The disease recovery was compared between the two groups, and the mechanism of epidural injection in elevating the block plane during spinal anesthesia combined with epidural anesthesia was analyzed. Results The anesthesia time and the time in need of off-bed activity in the study group were significantly shorter than those in the control group, and the differences were statistically significant（ P 0.05）. The dosage of anesthetics in the study group was significantly lower than those in the control group, and the difference was statistically significant（P0.05）. The range of block plane in the study group was significantly larger than that in the control group, and the difference was statistically significant（P 0.05）. Conclusion Spinal anesthesia combined with epidural anesthesia can significantly shorten the treatment time of the disease, effectively reduce the dosage of drugs and make the block plane effectively improved. The intervention effect is ideal, which is worthy of widely clinical recommendation.

关 键 词：腰麻联合硬膜外麻醉 硬膜外注药 机制分析 阻滞平面 

分 类 号：R614[医药卫生—麻醉学]