【摘要】 目的 比较脊髓腔麻醉(脊麻)—硬膜外联合麻醉(CSEA)和硬膜外麻醉(EA)在阴式子宫切除术中的应用。 方法 选择子宫脱垂、子宫肌瘤患者60例，随机分为CSEA组(30例)和EA组(30例)。CSEA组选L 3～4 用B—D公司生产的“针内针”穿刺，EA组选L 2～3 用国产硬膜外穿刺针进行穿刺。两组患者麻醉平面均调节在T 8～10 间。 结果 CSEA组诱导期短，Bromage评分高，用药量少，手术时间短，与EA组相比差异有显著性(P<0.01或P<0.05)。 结论 CSEA起效迅速、阻滞完善，盆底肌肉松弛完全，更适用于阴式子宫全切术。

    关键词 脊麻—硬膜外联合麻醉 阴式子宫全切术

    Application of combined spinal epidural anesthesia for vaginal total hysterectomy

    Lu Guojuan，Zhao Yiqiao，Yuan Songhua

    Maternal and Child Health Hospital of Xiashan，Zhanjiang524013.

    【Abstract】 Objective To compare the effect of combined spinal epidural anesthesia(CSEA)and epidural anesthesia(EA)on vaginal total hysterectomy.Methods 60patients with myoma of uterus undergoing vaginal total hysterectomy were selected.They were randomly divided into CSEA group(60cases)and EA group(60cases).The patients of CSEA group were punctured with needle—in—needle made by B—D company in L 3～4 .The patients of EA group were punctured with18G needle of epidural in L 2～3.To prevent stretch reflex level of anesthesia of all patients were controlled at level L 8～10 .Results Induction period of CSEA group was shorter ......