摘要
目的:比较连续腰麻及腰麻联合硬膜外麻醉在下肢延长术中的麻醉效果及其对血流动力学的影响。方法:选择下肢延长术患者40例,随机分为连续腰麻(CSA)组和腰麻联合硬膜外麻醉(CSEA)组,每组各20例,CSA组通过留置的导管首次向蛛网膜下腔注入腰麻药1.5 ml(药液配制为0.75%左旋布吡卡因5 ml+3%麻黄素0.3 ml+50%葡萄糖液0.7 ml),麻醉平面控制在胸10～12水平,手术开始后1.5 h追加配制好的腰麻药0.5 ml;CSEA组腰麻药配制同CSA组,腰麻穿刺成功后一次性注入2 ml,控制平面在胸10～12水平,1.5 h后硬膜外追加0.375%左旋布吡卡因和1%利多卡因混合液5 ml。术中视患者情况随时追加。术中连续监测血流动力学变化,观察麻醉效果。结果:CSA组镇痛效果良好,CSEA组5例患者有轻微痛感,两组患者生命体征平稳。结论:连续腰麻用于下肢延长术效果确切,血流动力学稳定。
Objective： To compare the anesthetic effects and hemodynamics of continuous spinal anesthesia （CSA） and combined spinal-epidural anesthesia （CSEA） in the patients undergoing limb lengthening. Methods： Forty patients undergoing selective limb lengthening were randomly divided into two groups. In group CSA （n=20）, 1.5 ml liquid of the preparation （0.75% levo-bupivacaine 5 ml ＋ ephedrine 10 mg＋50% glucose 0.7 ml）were infused into subarachnoid cavity through the catheter. The upper blocked level was at T10-12, and 0.5 ml liquid of the preparation （same to that of group CSA） were added 1.5 h after operation beginning. In group CSEA （n=20）, 2 ml liquid of the preparation were infused into subarachnoid cavity. The upper blocked level was at T10-12, and 5 ml mixture of 0.375% levobupivacaine and 1% lidocaine were infused into epidural cavity 1.5 h after operation beginning. The homodynamic changes and anesthetic effects were monitored during the operations. Results： The analgesic effect in group CSA was better than that of group CSEA, and 5 patients felt painful slightly in group CSEA. Conclusion： Continuous spinal anesthesia is effective in the patients undergoing limb lengthening and has stable hemodynamics.
出处
《天津医科大学学报》
2006年第2期209-210,共2页
Journal of Tianjin Medical University
