Rawal Narinder
Department of Anaesthesiology and Intensive Care, Orebro University Hospital, Orebro, Sweden.
Curr Opin Anaesthesiol. 2005 Oct;18(5):518-21. doi: 10.1097/01.aco.0000182565.25057.b3.
The purpose of this review is to present the most important recent studies on the clinical use of the combined spinal-epidural technique.
The predominant recent literature on the combined spinal-epidural technique involves its use in obstetrics. A 2004 UK survey showed that the use of the technique is increasing. Studies are presented which show the role of intrathecal drug selection for improving the quality of the combined spinal-epidural technique for anaesthesia for Caesarean section. The pros and cons of using the method as opposed to traditional epidural for labour analgesia are still being debated; the results of a meta-analysis show that combined spinal-epidural provides faster onset of analgesia and increased maternal satisfaction but the incidence of pruritus is high. This review also looks at some technical aspects of the technique.
The use of combined spinal-epidural is widespread and increasing particularly in obstetric anaesthesia and analgesia. Recent literature provides new information about the choice of drugs and technical aspects of the technique and also about its advantages and drawbacks in obstetric and non-obstetric patients.
本综述旨在介绍近期关于腰麻-硬膜外联合技术临床应用的最重要研究。
近期关于腰麻-硬膜外联合技术的主要文献涉及其在产科的应用。2004年英国的一项调查显示该技术的使用正在增加。文中呈现的研究表明鞘内药物选择对提高剖宫产腰麻-硬膜外联合麻醉技术质量的作用。与传统硬膜外用于分娩镇痛相比，使用该方法的利弊仍在争论中；一项荟萃分析结果显示腰麻-硬膜外联合技术起效更快且产妇满意度更高，但瘙痒发生率较高。本综述还探讨了该技术的一些技术方面。
腰麻-硬膜外联合技术的应用广泛且不断增加，尤其在产科麻醉和镇痛方面。近期文献提供了有关药物选择、技术方面以及该技术在产科和非产科患者中的优缺点的新信息。
