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脊麻硬膜外联合麻醉时硬膜外试验剂量有效性的观察
http://www.100md.com 《潍坊医学院学报》 2000年第1期
     作者:黄科昌 殷玉水 郑吉健 王秀莹

    单位:潍坊医学院附属医院麻醉科 潍坊 261031

    关键词:麻醉;脊髓;麻醉;硬膜外;试验剂量;肾上腺素

    潍坊医学院000123摘 要:目的观察脊麻硬膜外联合麻醉(CSEA)时脊麻(SA)作用是否影响含肾上腺素硬膜外试验剂量(TD)的有效性。方法25例CSEA病人,静脉或硬膜外注射2%利多卡因3ml(含肾上腺素15ug)。SA前仅静注,SA后30~40min时先后随机交叉间隔10min静脉和硬膜外注药。观察SA最大平面和注药后峰-峰HR(ΔHR)、SBP变化(ΔSBP)和自觉症状。以ΔHR≥20次/min、ΔSBP≥2kPa或有心慌、头晕为阳性循环反应。结果①SA前后静注TD后SBP和HR均明显增高(P<0.01),但硬膜外TD无明显变化(P>0.05)。②SA前和SA中比较,ΔHR、ΔSBP和阳性循环反应率差异无显著性(P>0.05)。③SA后静注TD时,ΔHR和ΔSBP与SA最大平面均无明显相关(rs分别为0.316和0.057,P>0.05)。结论CSEA时SA作用并不影响TD判断注入血管的准确性。
, 百拇医药
    分类号:R614.4+2 文献标识码:A

    The Efficacy of Epidural Test Doses during Combined Spinal-Epidural Anaesthesia

    Huang Kechang ,YinYushui ,Zheng Jijian

    (Department of Anaesthesiology,Affiliated Hospital of Weifang Medical College,Weifang,261031)

    Abstract:Objective To determine the effect of spinal anesthesia(SA)during combined spinal-epidural(CSEA)on the efficacy of epinephrine test dose(TD)for the detection of uninteneional intravascular injection.Method Twenty-five patients were received CSEA.TDs(epinephrine 15ug in 2%lidocaine 3ml)were injected intravenously before and 30~40min after SA and epidurally after SA.After SA,intravenous and epidural injection were randomjed,cross-over with 10-minute interval.The maxinum cephalad levels of SA as well as peak-to-peak HR(ΔHR),changes of SBP(ΔSBP),the symptoms after injection of TDs were observed.Positive hemodynamic criteria were defined as ΔHR≥20 bpm,or ΔSBP≥2.0kPa,or appearance of such symptom as palpation and dizziness.Result Intravenous TD increased HR and SBP both before and after SA didn’t(P<0.01),where as epidural TD after SA did not(P>0.05).The hemodynamic responses of intravenous TD before and after SA were found between the ΔHR or ΔSBP of intravenous TD and the level of anesthesia(rs=0.316 and 0.057,respectively,P>0.05).Conclusion The presence of SA does not affect the efficacy of epinephrine TD for the detection of unintentionally intravenous injection by posnitive hemodynamic criteria during CSEA.
, 百拇医药
    Keywords:Anaesthesia,spinal;Anaesthesia,epidural;Test doses;Epinephrine

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, 百拇医药
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, 百拇医药
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    收稿日期:1999-04-09, 百拇医药