多侧孔硬膜外麻醉导管用于阑尾切除术的临床观察

目的比较多侧孔硬膜外麻醉导管与普通硬膜外麻醉导管在阑尾炎切除术行硬膜外麻醉时的麻醉效果。方法选择ASAⅠ～Ⅱ级行阑尾切除术病人60例，随机分成A、B两组。A组置入多侧孔硬膜外麻醉导管，B组置入普通硬膜外麻醉导管，两组均选择T11-12间隙硬膜外穿刺。置管成功平卧后硬膜外腔注入2％利多卡因，首量3mg／kg。记录两组的麻醉平面、麻醉起效时间及麻醉前后的血压、心率变化，评估麻醉效果。结果A组麻醉平面出现明显较B组快，阻滞平面较B组高，肌松效果明显优于B组，牵拉反应及辅助用药B组较A组明显增多，A组的麻醉效果优良率明显好于B组。结论用多侧孔硬膜外麻醉导管行阑尾切除术的硬膜外麻醉比用普通硬膜外麻醉导管起效快，阻滞效果佳，肌松好，牵拉反应轻，辅助用药少，是一种可行的麻醉方法。

The effect of microporous epidural catheter applied in appendectomy

Objective To evaluate the effect of porous or ordinary epidural catheter applied in appendectomy with epidural anesthesia.Methods 60 cases(ASAⅠ～Ⅱ) undergoing appendectomy under epidural anesthesia were randomly allocated into two groups (n=30 in each group).All patients were given epidural anesthesia at the 12th spinal segment.Group A were inserted porous epidural catheter,while group B received normal epidural catheter.Both groups were received epidural administration with 2%lidocaine 3mg/ kg as first dose.The epidural block level ,the onset time ,the traction reflexes and the muscle relax effect were recorded.The artery blood pressure (BP)and the heart rate(HR) were measured.As well the anesthesic effect was assessed.Results Significant difference in the epidural block level,the onset time ,the traction reflexes,the regimens and the muscle relax effect(P< 0.05) were found between the two groups.The anesthesic effect in group A was better than that in group B.Conclusions The porous epidural catheter applied in appendectomy under epidural anesthesia were associated with faster onset time ,better muscle relax effect,little regimens and slight traction reflexes.We concluded this was a feasibile and reliable method.