一次性低阻力注射器在硬膜外穿刺中的应用

目的 评估一次性低阻力注射器（SLR）在硬膜外穿刺中的应用价值.方法 选择择期拟在硬膜外或蛛网膜下隙联合硬膜外麻醉下手术的患者132例,采用随机数字表法均分为玻璃注射器（GS）组和SLR组,每组66例.GS组采用传统GS行硬膜外穿刺,SLR组采用SLR行硬膜外穿刺.评价比较两组注射器外观有无缺陷,使用过程中各组件连接牢固度,有无脱落、断裂、漏液、漏气和堵塞现象.观察两组心率、血压和脉搏血氧饱和度及有无不良事件.结果 SLR组注射器除1例稍有阻力但不影响使用外,其余各组件连接牢固,表面无缺陷,刻度清晰,颜色均匀,未观察到断裂、漏液、漏气和堵塞现象,抽吸药液和空气阻力小;GS组注射器表面无缺陷,刻度清晰,颜色均匀,3例连接松动,1例使用时断裂,5例有漏液、漏气,3例抽吸药液或空气干涩阻力大以0.9％氯化钠反复湿润后勉强使用,两组外观、使用情况比较差异有统计学意义（x2=10.324 5,P=0.001 3）.两组一次穿刺成功、前三次穿刺成功和注射空气时负压灵敏性比较差异无统计学意义（P＞0.05）.结论 SLR值得在硬膜外穿刺中使用.

Application of disposable syringe of low resistance in epidural puncture

Objective To assess the application value of disposable syringe of low resistance （SLR） in epidural puncture.Methods One hundred and thirty-two patients scheduled to undergoing selective operation under epidural or combined epidural-spinal anesthesia were divided into glass syringe （GS） group and SLR group with 66 cases each by random digits table method.GS was applied in local anesthesia and epidural puncture with loss of resistance in GS group.While SLR was used in SLR group.The defect of the syringes＇ appearance was evaluated.The fastness between each sub-unit during the procedure was observed.The rupture,dropping,leakage,air leakage and blockage were also estimated.The heart rate,blood pressure,oxygen saturation and other adverse events were also observed.Results In SLR group,syringe excepted 1 case of slight resistance but did not affect the use,the rest of the components connected firmly,surface without defects,clear scale uniform color,not observed rupture,air leakage,leakage and blockage phenomenon,pump liquid and air resistance was small.In GS group,syringe surface without defects,clear scale uniform color,3 cases had loose connection,1 case with rupture when using,5 cases with air leakage and leakage,3 cases of pumping liquid or dry air resistance to 0.9% sodium chloride and moist after use.There was significant difference in appearance and usage between two groups （x2 =10.324 5,P =0.001 3）.There was no significant difference in a puncture success,first three puncture success and inject air negative pressure sensitivity between two groups （P 〉 0.05）.Conclusion SLR is worth to be applied in epidural puncture.