联合腰麻硬膜外麻醉用于子宫全切除手术的临床研究

目的比较联合腰麻硬膜外麻醉与单纯硬膜外麻醉在妇科全子宫切除术中的麻醉效果，并发症发生率和血流动力学的影响。方法选择择期全子宫切除术病人60例，随机分为CSEA组（联合腰麻硬膜外麻醉）和CEA组（连续硬膜外麻醉）。结果与CEA组比较，CSEA组麻醉显效时间快，麻醉平面迭T6时间和最高平面时间短，而且镇痛效果好，肌松效果好，两组比较差异有显著性（P〈0．05或P〈0．01）。术中低血压、恶心、呕吐、寒战发生率两组无差异，两组术后头痛、腰背痛发生率亦无统计差异。结论CSEA为临床全子宫切除术提供了一种作用迅速、麻醉完善、并发症发生率低、切实可行的麻醉方法。

Clinic invastigation of combined spind-epidural anesthesia in complete hysterectomy

Objective] To valuate efficacy and the incidence of complication and homodynamic changes in the combined spinal-epidural anesthesia (CSEA) and continuous epidural anesthesia (CEA) in complete hysterectomy. Methods] Sixty patients scheduled to undergo complete hysterectomy were randomly assigned to two groups:thirty patients received CSEA (CSEA group) and thirty patients received CEA (CEA group). Results] Compared with the CEA group ,CSEA group had following advantages:earlie onset times of anesthesia, the shorter time of anesthesia level to T6 and maximum level, smaller dose of local anesthesia, better effect of analgesic pain and more intensive motor block (P <0.05 or P <0.01). There was difference between the two groups in the incidence of hypotension, nausea, vomiting, chill, postoperation backache and headache. Conclusion] CSEA provides a better anesthesia way for complete hysterectomy.