Rawal N
Department of Anesthesiology and Intensive Care, Orebro Medical Center Hospital, Sweden.
Ann Acad Med Singap. 1994 Nov;23(6 Suppl):104-7.
Although epidural and spinal blocks are well-accepted regional techniques in obstetrics, they have several disadvantages. Combined spinal-epidural (CSE) technique reduces or eliminates the risks of these disadvantages. The sequential CSE technique can reduce the incidence and severity of maternal hypotension. CSE block combines the rapidity, density and reliability of spinal block with the flexibility of continuous epidural to extend the duration of analgesia. It has been used in thousands of patients without any reports of major problems. Catheter penetration through the dural hole though unlikely is not impossible. Before any injection in the epidural catheter, its position should always be confirmed by aspiration test. The technique should be used only by those who are experienced in spinal and epidural blocks. CSE is an important addition to the armamentarium of the obstetric anaesthesiologist.
尽管硬膜外阻滞和脊髓阻滞在产科是广泛接受的区域技术，但它们有几个缺点。腰麻-硬膜外联合（CSE）技术可减少或消除这些缺点带来的风险。序贯CSE技术可降低产妇低血压的发生率和严重程度。CSE阻滞将脊髓阻滞的快速性、密度和可靠性与连续硬膜外的灵活性相结合，以延长镇痛时间。它已应用于数千例患者，没有任何重大问题的报告。虽然导管穿过硬脊膜孔不太可能，但并非不可能。在硬膜外导管内进行任何注射之前，应始终通过回抽试验确认其位置。该技术仅应由有脊髓和硬膜外阻滞经验的人员使用。CSE是产科麻醉医生的重要补充手段。
