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目的 比较腰硬联合麻醉 (CSEA)与硬膜外麻醉在子宫切除术中的应用效果。方法 选择行子宫切除术病人 6 0例 ,ASAⅠ～Ⅱ级 ,随机分为观察组和对照组 ,各 30例。观察组采用两点法腰硬联合麻醉 ;对照组采用两点法硬膜外麻醉。观察两组病例阻滞节段数、麻醉诱导时间、首次局麻药量、局麻药总量、术中升压药和辅助镇静药情况、手术时间及术后头痛情况。结果 腰硬联合麻醉起效快、运动神经阻滞完整 ,局麻药用量少 ,与硬膜外比较差异有显著意义 (P <0 0 5 ) ,且无术后头痛发生。结论 腰硬联合麻醉可为子宫切除术提供完善的止痛、完全的肌松、生命体征平稳、安全合理的麻醉方法。
Objective To compare the effect of spinal epidural anesthesia (CSEA) with epidural anesthesia in hysterectomy. Methods Sixty patients undergoing hysterectomy, ASA Ⅰ ~ Ⅱ were randomly divided into observation group and control group, with 30 cases in each group. Observation group using two-point method of joint spinal anesthesia; two-point control group using epidural anesthesia. The number of blockage, anesthesia induction time, first local anesthetic dose, total local anesthetic dose, intraoperative vasopressor and auxiliary sedatives, operation time and postoperative headache were observed. Results The combined spinal and epidural anesthesia developed quickly, with complete motor nerve block, less local anesthetic dosage and significant difference compared with epidural (P <0.05), and no postoperative headache occurred. Conclusion Combined spinal and epidural anesthesia can provide perfect hysterectomy analgesic, complete muscle relaxation, stable vital signs, safe and reasonable method of anesthesia.