摘要
目的观察妊娠对硬膜外麻醉中腰骶段阻滞效果的影响。方法择期剖宫产或子宫肌瘤切除术患者50例分为妊娠组和非妊娠组,每组25例。选择L1～2间隙硬膜外穿刺置管,分别给予试验剂量2%利多卡因5ml和负荷剂量1%罗哌卡因8ml,观察阻滞平面,采用重复电刺激测试右侧L2、S1和S3皮肤区域的疼痛阈值变化,记录Bromage评分。结果妊娠组头侧扩散平面高于非妊娠组,非妊娠组患者尾侧扩散平面低于妊娠组(P<0.05)。两组的运动评分差异无统计学意义。两组患者L2区疼痛阈值均高于S1、S3区,疼痛阈值随时间延长而增高。结论妊娠能够增加硬膜外麻醉的头侧扩散,但并不能增加腰骶段麻醉的阻滞效果。硬膜外麻醉中妊娠与非妊娠患者骶段阻滞起效均较迟缓。
Objective To observe the pregnancy on the efficacy of lumbosacral blockade of epidural anesthesia. Methods Fifty patients under lumbar epidural anesthesia were divided into two groups of pregnant（undergoing ceasarean section） and nonpregnant （undergoing hysterectomy） with 25 cases each. Epidural puncture was performed at the L1-2 interspace and the epidural catheter was inserted. 2% lidocaine 5 ml was injected as a test dose,which was followed by 1% ropivacaine 8 ml. The cephalad and caudal anesthetic planes were checked. The changes of analgesia threshold at the dermatomes L2, S1 and S3 on the right side examined with reduplicate electric stimulation modus. Bromage score was record as well Results The cephalad.plane of pregnant group was higher than that of non-pregnant group ,but the caudal plane of pregnant group was less than that of non-pregnant group （P〈0.05）. No differences in Bromage scores and pain threshold at the L2, S1 or S3 segments were found between the two groups. The pain thresholds were significantly higher at L2 than those at S1 and S3 dermatomes in both groups （P〈0.05）. Conclusion Pregnancy enhances the cephalad spread of local anesthetics,but does not improve the efficacy of blockade in the lumbosacral area. The onset of epidural blockade of lumbosacral portion is delayed in both pregnant and non-pregnant women.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2009年第1期29-31,共3页
Journal of Clinical Anesthesiology
