腰硬联合麻醉与持续硬膜外麻醉在全子宫切除术中的应用效果

目的:分析全子宫切除术采用腰硬联合麻醉与持续硬膜外麻醉效果,为临床麻醉提供参考.方法:选取我院在2013年12月至2015年2月行子宫切除术患者86例为研究对象,随机分为联合麻醉组和硬膜外麻醉组各43例,联合麻醉组患者采用腰硬联合麻醉,硬膜外麻醉患者采用持续硬膜外麻醉,记录患者平均动脉压和心率变化,分析不同时间点两组患者麻醉效果.结果:联合麻醉组患者麻醉起效时间短于硬膜外麻醉,P<0.05,两组患者手术时间差异无统计学意义,联合麻醉组患者麻醉药用量低于硬膜外麻醉组,P<0.05.不同时刻,联合麻醉组患者MAP、HR和血氧饱和度变化平稳,变化幅度低于硬膜外麻醉组,P<0.05.观察组患者麻醉总优良率高于对照组,P<0.05,观察组肌肉松弛情况优于对照组,P<0.05,两组患者不良反应发生率差异无统计学意义(P>0.05).结论:全子宫切除术中采用腰硬联合麻醉方式简单安全有效,具有推广价值.

The Application Effect of Spinal Epidural Anesthesia Combined Continuous Epidural Anesthesia in Total Hysterectomy

Objective:To analysis the application effect of spinal epidural anesthesia combined continu-ous epidural anesthesia in total hysterectomy, and to provide reference for clinical anesthesia. Methods:86 patients with total hysterectomy admitted in our hospital from December 2013 to February 2015 were selected. All the patients were randomly average divided into anesthesia group and epidural anesthesia group. Anesthesia group patients were taken anesthesia of combined spinal epidural anesthesia, epidural anesthesia group pa-tients were taken anesthesia of continuous epidural anesthesia, the mean arterial pressure and heart rate were recorded, anesthetic effect of patients were compared. Results:Joint anesthesia onset time of anesthesia was significantly shorter than the epidural anesthesia group, P <0.05, two groups of patients no significant differ-ence in operative time, the amount of anesthetic in anesthesia group was significantly lower than epidural anes-thesia group, P <0.05. Different time, anesthesia group MAP, HR and oxygen saturation smooth change, the change was significantly lower than the epidural anesthesia group, P <0. 05. The total fine rate observed on Narcotic was significantly higher than epidural anesthesia group, P <0.05, a muscle relaxant anesthesia group was significantly better than the epidural anesthesia group, P <0. 05, two groups of patients with adverse e-vents was no significant difference, P> 0.05. Conclusion:The method of spinal epidural anesthesia combined continuous epidural anesthesia in total hysterectomy is simple, safe and effective.