摘要
目的观察25G细针侧隐窝入路单次腰麻应用于肥胖产妇剖宫产的临床效果。方法选择行剖宫产手术的肥胖产妇60例,随机分为正中入路组(N组)与侧隐窝入路组(L组),各30例。N组以25G腰麻细针于L3～L4脊柱正中入路穿刺,L组以L3～L4小关节内缘侧隐窝入路穿入蛛网膜下腔,注入0. 5%罗哌卡因重比重液3. 0 m L。观察并记录2组患者麻醉穿刺次数与成功率、麻醉起效时间、阻滞平面及效果,比较2组患者头痛、术后腰背部疼痛及神经损伤等不良反应发生情况。结果 2组患者麻醉起效时间、阻滞平面及效果均无统计学差异(P> 0. 05); L组人均穿刺次数显著低于N组,穿刺成功率显著高于N组(P <0. 05); L组穿刺时神经根刺激症状发生率较N组高,但差异无统计学意义(P> 0. 05); 2组患者均未出现头痛、神经损伤等不良反应。结论 25G细针侧隐窝入路单次腰麻应用于肥胖产妇剖宫产安全有效,可作为椎管内麻醉常规正中入路穿刺困难患者的备选方案。
Objective To observe the clinical efficacy of single lumbar anesthesia by 25G fine needle lateral crypt approach for the maternal obesity patients with cesarean section.Methods Sixty elderly obesity patients with cesarean section in our hospital were randomly divided into median approach group(group N,n=30)and lateral crypt approach(group L,n=30),given median approach puncture between L 3 and L 4 by 25G fine needle,0.5%hyperbaric ropivacaine for 3.0 mL by lateral crypt approach between L 3 and L 4,respectively.The puncture times and success rate,time of onset of anesthesia,the block plane and efficacy were observed,and headache,lumbago,lower limb pain and neurological injury were recorded.Results There was no significant difference in onset time,block plane and efficacy between the two groups(P>0.05).The puncture times in group L was lower,and success rate was significantly higher than that of group N(P<0.05).The incidence of irritation of nerve root in group N was higher than that of group L,but there was no statistical significant difference(P>0.05).No adverse reactions such as headache and nerve injury occurred in the two groups.Conclusion Single spinal anesthesia though lateral crypt approach is safe and effective for the low-extremity fracture surgery in elderly patients,which can be an alternative for spinal anesthesia patients with median approach puncture difficulties.
作者
唐在荣
TANG Zairong(Department of Anesthesiology,Gaoyou Hospital of Traditional Chinese Medicine,Gaoyou,Jiangsu,225600)
出处
《实用临床医药杂志》
CAS
2018年第24期69-71,共3页
Journal of Clinical Medicine in Practice
关键词
细针
侧隐窝
腰麻
肥胖
妊娠
剖宫产
fine needle
lateral crypt
lumbar anesthesia
obesity
pregnancy
cesarean section
