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剖宫产术中使用Sprotte针行蛛网膜下腔阻滞时正中与旁正中入路的随机对照研究:探寻最佳方法

A Randomized Comparative Study on Median and Paramedian Approaches for Subarachnoid Block using Sprotte Needle in the Cesarean Section: Quest for the Best.

作者信息

Kumari Reena, Kumar Tushar, Hembrom Boniface, Ram Barun, Lakra Ladhu, Suwalka Usha

机构信息

Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

Department of Critical Care, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

出版信息

Anesth Essays Res. 2021 Jul-Sep;15(3):268-271. doi: 10.4103/aer.aer_130_21. Epub 2022 Feb 7.

Abstract

BACKGROUND

Since 1898 when August Bier, introduced spinal analgesia, there is lot of advancement made in the technique. There are various approaches and techniques for subarachnoid block.

AIM

The aim of this study is to compare median and paramedian approach for spinal anesthesia for cesarean delivery using Sprotte needle in terms of number of attempts, success rate, adverse effects, and complications.

MATERIALS AND METHODS

One hundred patients were randomly divided into two equal groups and underwent subarachnoid block in median and paramedical block for elective cesarean section.

RESULTS

There is no significant difference between the two groups. Mean with standard deviation in the number of attempts for subarachnoid block through media and paramedian approach is 1.18 ± 0.48 and 1.06 ± 0.24, respectively ( = 0.51). The incidence of postdural puncture headache (PDPH) and lower backache was insignificant in both the groups ( = 0.218 and 0.646, respectively).

CONCLUSIONS

Paramedian approach should not be considered as a reserve technique for spinal anesthesia and can be used as popularly as the median approach.

摘要

背景

自1898年奥古斯特·比尔引入脊髓镇痛法以来,该技术有了很大进展。蛛网膜下腔阻滞有多种进针途径和技术。

目的

本研究旨在比较使用Sprotte针行剖宫产脊髓麻醉时正中法和旁正中法在穿刺次数、成功率、不良反应及并发症方面的差异。

材料与方法

将100例患者随机分为两组,分别接受择期剖宫产的蛛网膜下腔阻滞正中法和旁正中法。

结果

两组间无显著差异。通过正中法和旁正中法进行蛛网膜下腔阻滞的平均穿刺次数及标准差分别为1.18±0.48和1.06±0.24(P=0.51)。两组的硬膜穿刺后头痛(PDPH)发生率和下背痛发生率均无统计学意义(分别为P=0.218和0.646)。

结论

旁正中法不应被视为脊髓麻醉的备用技术,其应用频率可与正中法一样广泛。

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