Kolawole I K, Bolaji B O
Department of Anaesthesia, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Niger J Med. 2002 Oct-Dec;11(4):153-5.
The use of subarachnoid block has become an established and reliable method of providing anaesthesia for lower abdominal and lower limb surgery. Unfortunately, it remains largely unappealing to a large number of our patients who sometimes associate it with paralysis. The aim of this study was to assess the efficiency and safety of subarachnoid block for lower abdominal and lower limb surgery in the University of Ilorin Teaching Hospital. This prospective study was carried out between January 1998 and August 2000 the University of Ilorin Teaching Hospital, Ilorin, Nigeria. One hundred and ten (110) consenting adult patients had subarachnoid block for lower abdominal and lower limb surgery over a period of two years and eight months Patients were assessed in the theatre as well as in the postanaesthetic recovery room and daily in the ward for five days. All complications related to anaesthesia were recorded and analysed. There were 75 (68%) male and 35 (32%) female patients. Ninety-six (87%) were elective and 14 (13%) were emergency cases. The specialty distribution of cases included 66 (60%) patients for Orthopaedic surgery, 16 (14.5%) for General Surgery and 13 (11.8%) for Urology. Intravenous ketamine and pentazocine were used to supplement anaesthesia in 12 (11%) of cases due to varying degrees of discomfort experienced by the patients. There was no case of total failure. Intra-operative complications included hypotension in 9(8.18%) patients which responded to saline infusion in 5 and vasoconstrictor in 4 cases, hypertension in 9 (8.18%) patients which responded to reassurance and midazolam sedation, and a brief episode of shivering in 9 (8.18%) patients treated by additional drape cover. The incidence of post-spinal headache was 2.7% in this study. Subarachnoid block still remains a very effective and safe anaesthetic technique for lower abdominal and lower limb surgery. The technique is cheap and effort should be made to increase patient awareness and its acceptability in the new millennium.
蛛网膜下腔阻滞已成为为下腹部及下肢手术提供麻醉的一种成熟且可靠的方法。不幸的是，对我们的许多患者来说，它在很大程度上仍然缺乏吸引力，他们有时会将其与瘫痪联系起来。本研究的目的是评估在伊洛林大学教学医院蛛网膜下腔阻滞用于下腹部及下肢手术的有效性和安全性。这项前瞻性研究于1998年1月至2000年8月在尼日利亚伊洛林的伊洛林大学教学医院进行。在两年零八个月的时间里，110名同意参与的成年患者接受了蛛网膜下腔阻滞用于下腹部及下肢手术。患者在手术室、麻醉后恢复室以及术后5天在病房每天都接受评估。记录并分析所有与麻醉相关的并发症。有75名（68%）男性和35名（32%）女性患者。96名（87%）为择期手术，14名（13%）为急诊病例。病例的专科分布包括66名（60%）骨科手术患者、16名（14.5%）普通外科患者和13名（11.8%）泌尿外科患者。由于患者出现不同程度的不适，12例（11%）病例使用静脉注射氯胺酮和喷他佐辛辅助麻醉。没有完全失败的病例。术中并发症包括9名（8.18%）患者出现低血压，其中5例通过输注生理盐水缓解，4例使用血管收缩剂；9名（8.18%）患者出现高血压，通过安慰和咪达唑仑镇静缓解；9名（8.18%）患者出现短暂寒战，通过增加覆盖巾治疗。本研究中脊麻后头痛的发生率为2.7%。蛛网膜下腔阻滞对于下腹部及下肢手术仍然是一种非常有效且安全的麻醉技术。该技术成本低廉，在新千年应努力提高患者的认识及其可接受性。
