不同穿刺方法在妇科腰-硬联合麻醉手术中的效果比较  

Comparison of the effect of different puncture methods in gynecological combined spinal and epidural anesthesia surgery

作　　者：王月民 WANG Yuemin(Operating Room,Heze Sixth People’s Hospital,Shandong Province,Heze 274000,China)

机构地区：[1]山东省菏泽市第六人民医院手术室,山东菏泽274000

出　　处：《妇儿健康导刊》2024年第1期20-23,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的探讨不同穿刺方法在妇科腰-硬联合麻醉手术中的效果。方法选取2021年3月至2023年3月菏泽市第六人民医院收治的90例患者作为研究对象,按照随机数字表法分为对照组和观察组,每组各45例。两组均采用腰-硬联合麻醉,对照组实施一点针内针穿刺,观察组实施二点针外针穿刺。比较两组操作效果、麻醉效果及不良反应发生情况。结果观察组置管困难率和置针时异物感率均低于对照组(P<0.05)。观察组穿刺所需时间长于对照组,达到T10及T12时间短于对照组,硬膜外追加局麻药量少于对照组(P<0.05)。两组起效后平均动脉压下降情况比较,差异无统计学意义(P>0.05)。观察组不良反应总发生率低于对照组(P<0.05)。结论采用二点针外针穿刺方法进行腰-硬联合麻醉延长了穿刺所需时间,但起效更快,阻滞效果理想,可减少硬膜外追加局麻药量及不良反应的发生。Objective To explore the effect of different puncture methods in gynecological combined spinal and epidural anesthesia surgery.Methods A total of 90 patients in Heze Sixth People’s Hospital from March 2021 to March 2023 were selected as the study objects.All the patients were divided into the control group and the observation group using the random number table method,with 45 cases in each group.Both the groups received combined spinal and epidural anesthesia.The control group underwent one point needle-through-needle puncture,while the observation group underwent two point external needle puncture.The operation effect,anesthetic effect and the incidence of adverse reactions of the two groups were compared.Results The difficulty rate of catheterization and foreign body sensation rate during needle placement in the observation group were lower than those in the control group(P<0.05).The puncture time was longer,the additional local anesthetic dosage for epidural anesthesia was less and the time to reach T10 and T12 was shorter in the observation group than that in the control group(P<0.05).There was no statistically significant difference in the mean arterial pressure decrease between the two groups after taking effect(P>0.05).The total incidence rate of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion The use of two point external needle puncture method for combined spinal and epidural anesthesia prolongs the time required for puncture,but the effect is faster and the blocking effect is ideal.It can reduce the additional local anesthetic dosage for epidural anesthesia and reduce the incidence of adverse reactions.

关 键 词：腰-硬联合麻醉 针内针 针外针 

分 类 号：R614[医药卫生—麻醉学]