硬膜外阻滞穿刺角度和置管长度的探讨(附2000例临床总结)

目的 :探讨硬膜外阻滞穿刺一针成功率 ,提高硬膜外阻滞临床效果。方法 :在硬膜外穿刺成功后 ,测量穿刺针针体和侧中线皮肤的夹角度 ,进针深度 ,硬膜外腔留置导管的长度。结果 :穿刺针针体和皮肤的夹角主要与棘突倾斜度有关 ,进针深度和患者性别、身高、体重有关 ,硬膜外腔留置导管不宜超过 4cm。结论 :参照穿刺点不同角度、深度 ,可显著提高穿刺成功率 ,缩短穿刺时间 ,减少患者痛苦及并发症 ,硬外腔留置导管最好 2～ 3cm。

Investigation of epidural block puncture angle and catheterization length (a report of 2 000 cases)

Objective: To investigate how to improve epidural block "single puncture" success rate and its clinical effect. Methods: After successful epidural puncture,angle between puncture needle and median body skin,depth of puncture,length of catheter placed in epidural space are measured respectively. Results: Angle between puncture needle and body skin is mainly relevant to spinous process sloping angle ,puncture depth,patients' genders,heights and weights as well. Length of catheter placed in epidural space should be no more than 4 cm. Conclusion: Through choosing varieties of puncture angle and depth,length of catheter placed in epidural space should be 2～3cm to improve "single puncture" success rate,reduce puncture time costs,and relieve patients of pains and complications.