腰麻硬膜外联合麻醉在剖宫产术中的应用  

COMBINED SPINAL-EPIDURAL ANESTHESIA FOR CESAREAN SECTION: A REPORT OF 5 000 CASES

作　　者：单祥英[1] 李生德[1] 魏建风 张荣君[2] 许茜[2] 

机构地区：[1]青岛市妇女儿童医疗保健中心麻醉科,山东青岛266012 [2]青岛市妇女儿童医疗保健中心妇产科,山东青岛266012

出　　处：《齐鲁医学杂志》2003年第4期400-401,共2页Medical Journal of Qilu

摘　　要：①目的　了解腰麻硬膜外联合麻醉用于剖宫产术的利弊。②方法　麻醉剖宫产 5 0 0 0例 ,其中一点穿刺 4 387例 ,选L2～ 3 或L3～ 4硬膜外间隙穿刺 ;两点穿刺者 6 13例 ,先行L1～ 2 或L2～ 3 硬膜外间隙穿刺 ,然后再行L2～ 3 或L3～ 4蛛网膜下隙穿刺 ;腰麻用药为轻密度液、重密度液各 2 5 0 0例 ;术后采用硬膜外镇痛。③结果5 0 0 0例产妇麻醉效果满意 ,不需硬膜外补充用药 ;98.6 7%的产妇术后硬膜外镇痛效果理想 ;7.30 %的产妇出现不良反应。Objective To investigate advantages and disadvantages of combined spinal-epidural anesthesia for cesarean section. Methods The combined anesthesia was applied to 5 000 cases. In which, one-point puncture was performed in 4 387 cases at L 2-3 or L 3-4 epidural interspace, tow-point puncture was done in 613 patients. Firstly, epidural puncture was done at L 1-2 or L 2-3 interspace; secondly, subarachnoid space puncture at L 2-3 or L 3-4 was used for spinal anesthesia in which hyperbaric or hypobaric solution was given to respective 2 500 cases. Epidural analgesia was applied postoperatively. Results The effect of anesthesia in 5000 cases was satisfactory, accounting for 98.67% . No supplementary analgesic was needed through epidural route. Adverse reactions were 7.30%. Conclusion The combined spinal-epidural anesthesia is ideal for cesarean section.

关 键 词：剖宫产术 腰麻 硬膜外麻醉 联合麻醉 临床应用 

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