摘要
目的:讨论小儿下肢手术硬膜外麻醉和腰-硬联合麻醉对患儿阻滞深度和血流动力的影响。方法:对60例手术患儿随机分成两组:A组穿刺针进入蛛网膜下腔后,即注入0.5%罗派卡因液0.5～1.0 ml(0.25 mg/kg),术中按需追加1.0%利多卡因和0.375%罗派卡因混合液。B组患儿穿刺针进入硬膜外腔后,然后注入2.0%利多卡因2 ml于硬外腔。在5～10 min内注入1.0%利多卡因和0.375%罗派卡因混合5～8ml。术中追加用药同A组,一般为首次量的1/2～1/3。用针刺法测定麻醉平面及阻滞时间。结果:A组痛觉阻滞平面上界达T8的时间明显短于B组(P<0.01),A组局麻药用量明显少于B组(P<0.01),A组肌松满意率93.3%,B组为67%。A组所有的患儿术中未用氯胺酮强化,仅有2例追加力月西1.0 mg。B组有7例对镇痛不能耐受,8例牵拉反应明显,15例患儿均氯胺酮间断静推至术终。结论:腰-硬联合麻醉比硬膜外麻醉起效快,循环影响小,阻滞完善。
Objective： To discuss block depth and hemodynamic effects of epidural anesthesia and combined spinal-epidural anesthesia on the operation of lower limb in children. Methods： 60 cases of operation were randomly divided into two groups.In group A,puncture needle into the subarachnoid space,namely the infusion of 0.5% ropivacaine solution 0.5-1.0ml（0.25mg/kg）,intraoperative required an additional 1% lignocaine and 0.375% ropivacaine mixture.In B group,the puncture needle into the epidural space,then 2% Lidocaine Injected in the epidural cavity 2ml.In 5-10 minutesinjection of 1% lidocaine and ropivacaine mixed 5-8ml 0.375%.Intraoperative additional medication with group A,the general for the first volume of 1/2-1/3.With acupuncture anesthesia plane and block time determination. Results： Hyperalgesia block plane bound up to T8 times in group A were significantly shorter in group B（P0.01）.A group of local anesthetic dosage was obviously less than group B（P0.01）.In group A muscle relaxants rate of satisfaction was 93.3%,67% in B group.All patients of A group were treated with an unused ketamine aggrandizement,only 2 cases with additional force on the West 1.0mg.7 cases in group B on analgesic intolerance,8 cases of visceral traction reaction obviously,15 cases patients had intermittent bolus to postoperative ketamine. Conclusion： lumbar-epidural anesthesia combined anesthesia than fast onset of effect,circulation,complete block.
出处
《河南医学研究》
CAS
2011年第4期456-458,共3页
Henan Medical Research
关键词
硬膜外腔
蛛网膜下腔
腰-硬联合
epidural cavity
subarachnoid space
lumbar-epidural
