Chan S Y, Tay H B, Thomas E
Anaesthesia Department, Kandang Kerbau Hospital, Singapore.
Anaesth Intensive Care. 1993 Aug;21(4):414-5. doi: 10.1177/0310057X9302100407.
Fifty-three patients presenting for minor gynaecological procedures received caudal blocks performed by residents. These residents used the standard technique which relied on the "give" felt as a needle penetrates the sacrococcygeal membrane and the loss of resistance to air when the needle is correctly placed. The "whoosh" test was noted by the supervising anaesthetist who did not reveal his findings to the residents. A positive test consisted of a characteristic "whoosh" sound on auscultation of the thoracolumbar region when 2 to 3 ml of air was injected into the caudal extradural space. The predictive value of a positive test was found to be 78%, 80.7% and 97.7% (P < 0.01) for a positive "give", loss of resistance and "whoosh" test respectively. Negative tests had no predictive value for "give" and loss of resistance whilst the predictive value of an absent "whoosh" was 100% (P < 0.05). Thus we conclude that the "whoosh" test is an excellent aid in the teaching of caudal anaesthesia.
五十三名接受小型妇科手术的患者接受了住院医生实施的骶管阻滞。这些住院医生采用标准技术，该技术依赖于针刺穿骶尾韧带时感觉到的“落空感”以及针正确放置时空气阻力的消失。监督麻醉师注意到了“呼呼”试验，但未将其结果告知住院医生。阳性试验是指当向骶管硬膜外间隙注入2至3毫升空气时，在胸腰段听诊出现特征性的“呼呼”声。结果发现，对于阳性“落空感”、阻力消失和“呼呼”试验，阳性试验的预测价值分别为78%、80.7%和97.7%（P<0.01）。阴性试验对“落空感”和阻力消失没有预测价值，而无“呼呼”声的预测价值为100%（P<0.05）。因此，我们得出结论，“呼呼”试验在骶管麻醉教学中是一种很好的辅助手段。
