Kopacz D J, Carpenter R L, Mulroy M F
Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington.
Reg Anesth. 1990 Jul-Aug;15(4):199-203.
Changes in epidural compliance were investigated before and after extracorporeal shock wave lithotripsy (ESWL) in 11 outpatients. Epidural pressures were unchanged acutely by ESWL (p greater than 0.15). In contrast to previous reports of failures of epidural anesthesia in patients having repeat ESWL treatments, a review of our population of patients having repeat ESWL indicates that epidural anesthesia is reliable and not associated with any greater failure rate than for initial ESWL treatments. The difference between our results and previous reports of high failure rates is likely due to differences in anesthetic and surgical techniques such as: (1) use of air for loss-of-resistance when locating the epidural space, (2) differences in the time interval between ESWL treatments, and (3) frequency of use of epidural catheters.
对11名门诊患者在体外冲击波碎石术（ESWL）前后的硬膜外顺应性变化进行了研究。ESWL对硬膜外压力无急性影响（p>0.15）。与之前关于接受重复ESWL治疗的患者硬膜外麻醉失败的报道相反，对我们接受重复ESWL治疗的患者群体的回顾表明，硬膜外麻醉是可靠的，且与初始ESWL治疗相比，失败率并无更高。我们的结果与之前高失败率报道之间的差异可能归因于麻醉和手术技术的不同，例如：（1）在定位硬膜外腔时使用空气进行阻力消失法，（2）ESWL治疗之间的时间间隔差异，以及（3）硬膜外导管的使用频率。
