Department of Women's Anaesthesia, Women's & Children's Hospital, Adelaide, Australia.
Anaesthesia. 2012 Dec;67(12):1356-63. doi: 10.1111/anae.12034. Epub 2012 Oct 12.
We investigated block heights that anaesthetists considered adequate for caesarean section to proceed under spinal anaesthesia. During 3 months, 15 obstetric anaesthetists recorded block height to touch, pinprick or cold when spinal anaesthesia was considered satisfactory for caesarean section to proceed. Median (IQR [range]) block height for touch, pinprick, first cold and icy were: T10 (T7-T12 [T3-L1]); T5 (T4-T6 [C7-L1]); T5 (T4-T6 [C7-L1]); and T3 (T2-T4 [C7-L1]), respectively. Modalities were significantly correlated for: touch and cold, p = 0.0001; touch and icy, p = 0.0007; touch and pinprick, p = 0.0018; cold and icy, p < 0.0001; cold and pinprick, p = 0.0001; icy and pinprick, p < 0.0001. Pairwise comparisons showed differences between all modalities (p < 0.001) apart from pinprick and first cold (p = 0.94). All women had satisfactory anaesthesia despite 76 (81%) having a block to touch below T6. Single modality assessment of block height, particularly using touch, may erroneously indicate inadequate anaesthesia for caesarean section.
我们研究了麻醉师认为在脊髓麻醉下进行剖宫产手术时足够的阻滞高度。在 3 个月期间，15 名产科麻醉师在脊髓麻醉被认为足以进行剖宫产手术时记录了触诊、针刺或冷觉的阻滞高度。触诊、针刺、冷觉和冰冷觉阻滞高度的中位数（IQR[范围]）分别为：T10（T7-T12[T3-L1]）；T5（T4-T6[C7-L1]）；T5（T4-T6[C7-L1]）；和 T3（T2-T4[C7-L1]）。各种感觉模式之间存在显著相关性：触诊和冷觉，p=0.0001；触诊和冰冷觉，p=0.0007；触诊和针刺觉，p=0.0018；冷觉和冰冷觉，p<0.0001；冷觉和针刺觉，p=0.0001；冰冷觉和针刺觉，p<0.0001。除了针刺觉和首次冷觉（p=0.94）之外，其余所有感觉模式之间的两两比较均存在差异（p<0.001）。尽管 76 名女性（81%）的触诊阻滞高度低于 T6，但所有女性均有满意的麻醉效果。单一感觉模式评估阻滞高度，特别是使用触诊，可能会错误地表明剖宫产手术的麻醉不足。
