硬膜外导管通畅度与子宫切除术患者硬膜外麻醉效果的关系

目的观察硬膜外导管通畅度与子宫切除术患者硬膜外麻醉效果的关系。方法择期行子宫切除术患者100例，于L2-3间隙行硬膜外穿刺，头向置管4cm成功后，按满足“从导管注入2ml空气无阻力，且可立即回抽约等量气体”两项条件的不同情况，即不同的硬膜外导管通畅度将患者分为3组：通畅组（A组43例）、基本通畅组（B组32例）、不通畅组（c组25例）。3组均硬膜外给予2％利多卡因5ml，5min后注入混合液14ml。观察患者感觉和运动阻滞效应及麻醉效果。结果3组间感觉阻滞达最高平面所需时间差异无统计学意义。从A组至C组，感觉、运动阻滞的起效时间逐渐延长，感觉阻滞所达最高平面逐渐降低；3组间运动阻滞程度、腹部肌肉松弛程度及麻醉效果差异有统计学意义，A组优于B组，B组优于C组。结论硬膜外导管通畅度可预测硬膜外麻醉效果。

Relationship between efficacy of the epidural anesthesia for hysterectomy with the unbiocked degree of epidural catheter

Objective To study the relationship between efficacy of the epidural anesthesia for hysterectomy with the un- blocked degree of epidural catheter. Methods When epidural anesthesia was performed at L2-3 interspace and the catheter was advanced 4cm into the epidural space in cephalic direction, one hundred ASA I or II female patients were divided into three groups ：the patients who complelely accorded with conditions that we could infuse two milliliter air into epidural cavity from cathe- ter easily and then pump back about the same volume gas immediately （group A）. the patients who reluctantly accorded with the above-mentioned conditions （group B） and the patients didn＇t accorded with conditions （group C）. Correct epidural catheter placement was confirmed with 2% lidocaine 5ml. epidural anesthesia was produce with mixed local anesthetic lgml. The effect of sensory and motor block and anesthetic efficacy were recorded. Rnsults There were 43,32 and 25 patients each in group A, B and group C. There was no significant difference in the time needed to reach the highest level of sensory block. From group A to group C, the onset time of sensory and motor block was lengthened, and the highest level of sensory block was lowered gradually. There were significant difference in anesthetic efficacy, and degree of motor block and abdominal muscle relaxation between three groups, group A better than group B,group B better than group C. Conclusion Tthe unblocked degree of epidural catheter could predict the effect of the epidural anesthesia.