Standl Thomas
Klinik für Anästhesie und operative Intensivmedizin, Städtischen Klinikums Solingen, Akademisches Lehrkrankenhaus, Universität Köln, Germany.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2007 May;42(5):342-9. doi: 10.1055/s-2007-981689.
Besides epidural analgesia combined spinal-epidural anaesthesia (CSE) is one of the favourite techniques of regional anaesthesia for pain relief in obstetric patients. CSE combines the advantage of spinal anaesthesia, e.g. rapid onset and reliable effect, with the advantage of continuous epidural anaesthesia, e.g. titration of analgesics and prolongation. While subarachnoid injection of solely opioids provides fast pain relief for nearly 2 hrs in the first stage of labour with an opportunity of ambulation for the parturient ("walking epidural"), the subarachnoid injection of a combination of low doses of opoids and local anaesthetics provides profound analgesia with minor motor blocking side effects for 1-2 hrs in the second stage of labour.
除了硬膜外镇痛，腰麻-硬膜外联合麻醉（CSE）是产科患者区域麻醉中最常用的疼痛缓解技术之一。CSE结合了腰麻的优点，如起效迅速和效果可靠，以及连续硬膜外麻醉的优点，如镇痛药滴定和延长作用时间。虽然单纯蛛网膜下腔注射阿片类药物可在第一产程中为产妇提供近2小时的快速疼痛缓解，并使其有机会活动（“可行走硬膜外麻醉”），但蛛网膜下腔注射低剂量阿片类药物和局部麻醉药的组合可在第二产程中提供1-2小时的深度镇痛，且运动阻滞副作用较小。
