Xie R, Liu Y P
Department of Anesthesiology, First Teaching Hospital, Beijing Medical University.
Chin Med J (Engl). 1991 Jun;104(6):510-5.
It is generally believed that epidural blocks are most widely used in China. However, there is yet no substantial study in this respect. A nation-wide survey appears to be necessary. Questionnaires were sent to 237 hospitals located in 6 geographically wide-scattered areas and to some military hospitals as well. 90 answers were obtained with complete data necessary for this survey. There are 1,304,214 administrations of epidural blocks documented in these 90 hospitals. Of which 38.8% are lumbar, 32% lower thoracic, 23% middle thoracic, 4.6% upper thoracic and 1.6% cervical blocks. These data showed that operations from the neck down to the lower extremities were performed under epidural block without discrimination of puncture location. 98.33% of the blocks were satisfactory to meet the need of operations. Persisting paresthesia occurred in 0.013% of these cases. The incidence of accidental puncture of dura was 0.32%. About 2/3 of these dura punctured cases received 1-4 times of repuncture. No correlation was found between repuncture and development of total spinal anesthesia. Among the complications, incidence of respiratory depression was 0.54%. However, only 5% of these depressed cases needed intubation and artificial ventilation. No signs of dura puncture were noticed, but subarachnoid block did appear in 0.04 of cases. Incidence of total spinal anesthesia was 0.013%. Not all, but a little more than half (54.6%) of the total spinal cases needed intubation and artificial ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)
一般认为硬膜外阻滞在中国应用最为广泛。然而，在这方面尚无实质性研究。全国性调查似乎很有必要。我们向分布在6个地域广泛的地区的237家医院以及一些军队医院发放了调查问卷。共获得90份包含本次调查所需完整数据的回复。这90家医院记录了1304214例硬膜外阻滞。其中，38.8%为腰部阻滞，32%为下胸部阻滞，23%为中胸部阻滞，4.6%为上胸部阻滞，1.6%为颈部阻滞。这些数据表明，从颈部到下肢的手术均在硬膜外阻滞下进行，而不考虑穿刺部位。98.33%的阻滞效果令人满意，能够满足手术需求。这些病例中持续性感觉异常的发生率为0.013%。硬脊膜意外穿刺的发生率为0.32%。约2/3的硬脊膜穿刺病例接受了1 - 4次重新穿刺。重新穿刺与全脊髓麻醉的发生之间未发现相关性。在并发症中，呼吸抑制的发生率为0.54%。然而，这些呼吸抑制病例中只有5%需要插管和人工通气。未发现硬脊膜穿刺的迹象，但有0.04%的病例出现了蛛网膜下腔阻滞。全脊髓麻醉的发生率为0.013%。并非所有全脊髓病例，但略多于一半（54.6%）的全脊髓病例需要插管和人工通气。（摘要截选至250字）
