腰麻联合硬膜外麻醉在子宫全切术中的应用比较

目的 :比较腰麻联合硬膜外麻醉与连续硬膜外麻醉在子宫全切手术中的麻醉效果及其对血流动力学的影响。方法 :择期全子宫切除术患者 6 0例 ,随机分为两组 :A组 30例行腰麻联合硬膜外麻醉 ,B组 30例行单纯连续硬膜外麻醉。结果 :腰麻联合硬膜外麻醉较单纯连续硬膜外麻醉起效时间快、阻滞范围广、肌肉松驰完善、局麻药用量少 ,呈显著差异性 (P<0 .0 1) ;二者在初次用药后 1h内的低血压发生率、血压波动及麻黄碱用量无明显差异 ,但血压下降最低值出现时间 A组明显早于 B组 (P<0 .0 1)。腰麻联合硬膜外麻醉后头痛发生率低。结论 :腰麻联合硬膜外麻醉为子宫全切除手术提供了一种起效迅速、神经阻滞完善、合并症较少的麻醉方法

Combined epidural-spinal anesthesia for hysterectomy

Objective:The study is to compare the effects and the fluctuation hemodynamic of combined spinal/epidural anestlesia and the cotinuous epidural anestlesia in the elective caesarean section.Methods:60 patients undergoing elective caesarean section prospectively randomized into two group:Group A(n=30) receiving CSEA Group B(n=30),receiving epidural anestlesia.Results:In group A we achieve a faster respouse,more perfective anestletic block at a lower dose than group B and the fluctuation of blood pressure theneeded dose of the epledrine didn′t have any difference,But the decrease of the blood pressure is earlier in group A than in group B,And in group B morepatients have purcture headache.Conclusion:CESA is the best anestleis method for caesarean section,Which has a fast resporse,perfective ansthetic block and fewer complication.