腰硬联合阻滞与硬膜外阻滞用于阑尾手术效果观察
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【摘要】目的：比较腰硬联合阻滞(CSEA)与单纯硬膜外阻滞(EA)在阑尾炎切除术的麻醉效果。方法：选择ASAⅠ～Ⅱ级行阑尾切除术病人166例，随机分成CSEA组(A组)和EA组(B组)，每组83例。A组行T11-12间隙硬膜外穿刺向上置管后再行k。间隙单次腰麻，腰麻药用0.5%等比重布比卡因2.0～2.5ml。B组行T11-12间隙硬膜外穿刺向上置管，平卧后硬膜外注入1.6%～2%利多卡因，首量8～12ml。结果：A组麻醉平面出现时间较B组明显快，且阻滞平面较B组高，肌松效果也明显优于B组，牵拉反应B组较A组明显增多，辅助用药B组也较A组明显增多。结论：CSEA用于阑尾切除术较EA麻醉起效快，阻滞效果佳，肌松好，牵拉反应轻，辅助用药少，是一种可行的麻醉方法。
【关键词】阑尾炎；腰硬联合阻滞麻醉；硬膜外阻滞麻醉；阑尾切除术
Combined spinal and epidural block anesthesia for surgery Effect of appendectomy
Ni Xin-ying
【Abstract】Objective: To compare the combined spinal block (CSEA) with a simple epidural anesthesia (EA) in the appendicitis excision of the anesthetic effect. Methods: ASA Ⅰ ~ Ⅱ grade appendectomy line 166 cases of patients were randomly divided into CSEA group (A) and EA group (B group), 83 cases of each group. A group of line T 11-12epidural space puncture after catheter upward k. Clearance Single spinal anesthesia, spinal anesthesia with isobaric 0.5% bupivacaine 2.0 ~ 2.5ml. Group B line T 11-12epidural space puncture tube upward, lying after the epidural injection of 1.6% ~ 2% lidocaine, the first volume of 8 ~ 12ml.The results: A group of the time-plane anesthesia was significantly faster than B, and block levels higher than B, the effect of muscle relaxation was significantly better than the B group, the more traction reaction Group A Group B increased significantly, support groups also use B than the A group was significantly increased. Conclusions: CSEA for appendectomy EA narcotic effect than the fast, block the effect of good muscle relaxation, and mild traction, auxiliary use less anesthesia is a feasible method.【Key Words】appendicitis; spinal anesthesia hardware; epidural anesthesia; appendectomy ......
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