腰麻辅助硬膜外麻醉在全子宫切除术中的应用分析

目的:观察腰麻辅助硬膜外麻醉在全子宫切除术中的应用效果。方法:选择328例全子宫切除术病人,随机分为试验组(143例)、对照组(185例),均取L_(1-2)棘突间隙行硬膜外腔穿刺置管,对照组常规用药,试验组另取L_(3-4)棘突间隙行腰麻,观察各组的麻醉效果,术中探查牵拉子宫时病人的反应,血压及心率的变化。结果:试验组的麻醉良好率、肌松情况优于对照组(P<0.01),骶神经阻滞情况试验组完全阻滞,而对照组出现骶神经阻滞不全,首次剂量试验组少于对照组(P<0.01)。牵拉子宫后各组病人血压、心率均较牵拉前下降,且与牵拉前比较有显著差异(P<0.05)。结论:在全子宫切除术中应用腰麻辅助硬膜外麻醉优于单纯硬膜外麻醉,有一定临床应用意义。

Analysis of Epidural Assisted with Spinal Anesthesia Used in Abdominal Hysterectomy

Objective:To evaluate the effect of epidural assisted with spinal anesthesia in abdominal hysterectomy. Methods 328 patients were randomly divided into two groups. Treatment group( n = 143) used L1-2 epidural anesthesia and L3-4 spinal anesthesia , comparative group(n=185) only used L1-2 epidural anesthesia. The effect of anesthesia, the reaction of patients during operation, and the change of BP、HR were observed and compared. Results:Treatment group was better than comparative group in the rate of anesthesia contentment and relaxed the muscles (P < 0.01) . Sacral nerve block was complete in treatment group, however, it was incomplete in comparative group. The first drug dose of treatmental group was less than comparative group( P < 0.01) . BP and HR of two groups both dropped than original records, with notable difference in statistics( P < 0.05) . Conclusion: Epidural assisted with spinal anesthesia is superior to single epidural anesthesia in abdominal hysterectomy, the thing has value in clinical use.