spinocath导管连续蛛网膜下隙阻滞在老年妇科肿瘤手术麻醉中的应用

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1、Spinocath导管连续蛛网膜下隙阻滞在老年妇科肿瘤手术麻醉中的应用作者：方曼菁，罗力冰，常峻，李艺，刘海根，杨祖权【摘要】目的比较连续腰麻(CSA)、腰-硬联合麻醉(CSEA)用于高龄妇科肿瘤手术患者的临床效应。方法择期妇科恶性肿瘤实施开腹广泛全子宫切除并盆腔淋巴清扫手术的患者60例，年龄70～78岁，ASAⅡ～Ⅳ级，分为CSA组(Ⅰ组，n=30)和CSEA(Ⅱ组，n=30)。CSEA组于L3～4间隙蛛网膜下腔注入0.5%布比卡因5.5～7.5mg，硬膜外用药一次2%利多卡因2～6ml，麻醉平面不够或时间超过60

2、min再追加2%利多卡因2～4ml。CSA组采用Spinocath导管针，于L3～4间隙穿刺，蛛网膜下腔置管2cm，首次剂量0.5%布比卡因5.0～6.5mg，手术90min后追加3.0～5.0mg。比较两组的阻滞平面、镇痛效果、肌松程度，循环变化及术后并发症等情况。结果以上两组在麻醉阻滞平面、镇痛效果、肌松程度。循环变化情况差异有统计学意义(P<0.05)。结论Spinocath连续腰麻用于老年患者，特别是施行妇科盆腔手术时，麻醉效果满意，肌松完全，对呼吸、循环系统干扰小，麻醉并发症少，是一种理想的麻醉方法。

3、【关键词】连续腰麻;妇科肿瘤;Spinocath导管　　[Abstract]ObjectiveTocomparetheclinicaleffectof8continuousspinalanesthesia(CSA)，spinalandepiduralanesthesia(CSEA)forelderlypatientswithgynecologicalmalignanttumor.MethodForselectiveimplementationoftheabdominalgynecologicalmalignancie

4、sextensivehysterectomyandpelviclymphnodedissectioninpatientswithpatients60cases，70～78yearsold，ASAⅡ～ⅣgradeweredividedintoCSAgroup(Ⅰgroup，n=30)andCsEA(Ⅱgroup，n=30).Toinvestigatetheeffectivenessoftheapplicationofthecontinuousspinalanesthesiaintheoperationofgynecol

5、ogicmalignanttumors.Methods90casesofgynecologicmalignanciesbecauseoftheimplementationofextensiveabdominalhysterectomyandpelviclymphnodedissectionpatientswererandomlydividedintotwogroups，combinedspinalandepiduralanesthesia(CSEAgroup，n=30)，continuousspinalanesthe

6、siagroup(CSAgroup，n=30).CSEAgroupnerewithL3～4spacesubarachnoidinjectionof0.5%bupivacaine5.5～7.5mg，a2%lidocaineepiduralmedication2～6ml，anesthesiaisnotenough，ormorethan60minandthendidanadditional2%lidocaine2～4ml.CSAgroupwereSpinocathcatheterneedle，attheL3～4spacep

7、uncture，subarachnoidcatheter2cm，thefirstdoseof0.5%bupivacainewas5.0～6.5mg，anadditionalwas3.0～5.0mgafter90minutesofsurgery.Comparedtheblockplane，analgesiceffect，degree8ofmusclerelaxation，circulationchangesandpostoperativecomplicationsandsoonintwogroups.ResultsTh

8、eblockplaneanalgesiceffect，degreeofmusclerelaxation，circulationchangesintwogroupsallhadallsignificantdifferences(P<0.05).ConclusionSpinocathcontinuousspinalanesthesiafore