腰硬联合麻醉不同注药速度对麻醉效果的影响

发布时间：2019-02-17 11:40

【摘要】：目的研究腰硬联合麻醉时不同注药速度对麻醉效果的影响。方法选取2010年1月至2014年1月在上海市浦东新区周浦医院接受妇科手术行腰硬联合麻醉的患者60例,按随机数字表法分为A、B、C三组,各20例。A、B、C三组分别以10、15、20 s注射0.75%罗哌卡因2 mL。观察三组患者的麻醉效果,检测麻醉后患者的感觉和运动阻滞情况,记录镇痛最高平面和及其出现时间,监测循环和呼吸功能。结果 A组T_6阻滞出现时间和最高平面出现时间显著早于B组和C组[(9.7±2.7)min比(11.5±2.1)min,(13.1±2.3)min;(11.4±2.4)min比(13.7±1.9)min,(16.7±2.8)min,P0.05]。B组和C组的并发症发生率显著低于A组[5%(1/20)、10%(2/20)比20%(4/20),P0.05]。C组最低血压值显著低于A组[(68.7±9.3)mmH g(1 mmH g=0.133 k Pa)比(73.7±8.1)mmH g,P0.05],最低血压出现时间显著晚于A组[(61.4±14.4)min比(31.5±10.5)min,P0.05]。结论实施腰硬联合麻醉时,将注药速度控制在15~20 s,患者的感觉阻滞和运动阻滞能够维持较久,循环较稳定,麻醉效果最优。
[Abstract]:Objective to study the effect of different injection speed on anesthesia effect during combined spinal-epidural anesthesia. Methods from January 2010 to January 2014, 60 patients undergoing gynecological surgery under combined spinal-epidural anesthesia in Zhoupu Hospital, Pudong New District, Shanghai, were randomly divided into three groups: group A (n = 20), and group C (n = 20). Group C was injected with 0.75% ropivacaine 2 mL. for 20 s with 10 ropivacaine. The anaesthesia effect of the three groups was observed, the sensory and motor block of the patients after anesthesia was detected, the maximum level and time of analgesia were recorded, and the circulatory and respiratory functions were monitored. Results the onset time of T6 block and the time of peak level in group A were significantly earlier than those in group B and group C [(9.7 卤2.7) min vs (11.5 卤2.1) min, (, 13.1 卤2.3) min;]. The incidence of complications in group B and group C was significantly lower than that in group A [5% (1 / 20), 10% (2 / 20) vs 20% (4 / 20)]. The lowest blood pressure in group C was significantly lower than that in group A [(68.7 卤9.3) mmH g (1 mmH GG 0.133 k Pa) vs (73.7 卤8.1) mmH GG P 0.05]. The minimum blood pressure was significantly later than that in group A [(61.4 卤14.4) min vs (31.5 卤10.5) min,P0.05]. Conclusion when combined spinal-epidural anesthesia is carried out, the speed of injection is controlled at 15 ~ 20 s, the sensory and motor block can be maintained for a long time, the circulation is stable, and the anesthetic effect is optimal.
【作者单位】：上海市浦东新区周浦医院麻醉科;
【基金】：上海市浦东新区周浦医院重点专科建设项目(ZP-XK-2015C-3)
【分类号】：R614

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