Department of Anesthesiology, Obstetrics and Gynecology Hospital, Fudan University, Shenyang Road 128#, Yangpu District, Shanghai, 200090, China,
J Clin Monit Comput. 2014 Jun;28(3):265-8. doi: 10.1007/s10877-013-9527-5. Epub 2013 Nov 7.
To evaluate the effect of preloading the epidural space with normal saline (NS) on the incidence of complications of epidural catheter placement and spinal anesthesia for cesarean section. Two hundred and ninety parturients at full term, who were scheduled for cesarean section under combined spinal-epidural anesthesia were randomly divided into two groups: group control (I) and group NS (II). The epidural puncture was performed at the estimated L3-4 interspace with a Tuohy needle attached to a 5 ml syringe. Loss of resistance to air was used to identify the epidural space. In group I no fluid was injected into the epidural space before insertion of the catheter; while in group II NS 5 ml was injected into the epidural space before catheter insertion. The incidence of blood vessel trauma and paraesthesia were evaluated. The effect of spinal anesthesia was evaluated. Blood vessel trauma in group II was significantly lower than in group I, P < 0.05. However, the incidence of paraesthesia was similar between the two groups, P > 0.05. Preloading the epidural space with NS can decrease the incidence of clinically apparent injury to blood vessels during epidural catheter placement, and can improve the effects of spinal analgesia, but does not reduce the incidence of paraesthesia.
为了评估在硬膜外腔预充生理盐水（NS）对剖宫产患者硬膜外导管置入并发症和脊髓麻醉发生率的影响。选择 290 例足月、拟在蛛网膜下腔-硬膜外联合麻醉下行剖宫产的产妇，随机分为两组：对照组（I 组）和 NS 组（II 组）。硬膜外穿刺在估计的 L3-4 间隙进行，使用连接 5ml 注射器的 Tuohy 针。使用空气阻力消失来识别硬膜外腔。I 组在插入导管前不向硬膜外腔注入任何液体；而 II 组在插入导管前向硬膜外腔注入 NS5ml。评估血管损伤和感觉异常的发生率。评估脊髓麻醉的效果。II 组血管损伤的发生率明显低于 I 组，P<0.05。然而，两组感觉异常的发生率相似，P>0.05。在硬膜外腔预充 NS 可以降低硬膜外导管置入期间血管明显损伤的发生率，并可以提高脊髓镇痛效果，但不会降低感觉异常的发生率。
