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[骶管硬膜外麻醉的应用前景]

[Prospects of the use of caudal epidural anesthesia].

作者信息

Polushin Iu S, Rostomashvili E T, Levshankov A I, Kostiuchenko A L, Bogatova G P

出版信息

Anesteziol Reanimatol. 1998 Sep-Oct(5):42-4.

PMID:9866247
Abstract

Caudal epidural anesthesia for interventions on the lower limbs and pelvic organs was used in 525 patients. A specific feature of the method is use of hypoosmolic local anesthetic solution (osmolality 260 mosmol/kg) containing lidocaine, 0.9% sodium chloride, and distilled water. Pathologic studies showed that in adult patients, at least 40 ml anesthetic should be injected into the caudal canal for adequate blocking. During surgery, caudal epidural anesthesia reliably protected from surgical trauma without side effects for respiration and circulation. The duration of analgesic effect was 3 +/- 0.5 h and even longer, if local anesthesia was potentiated with sedative drugs. No complications were observed, failures occurred in 5.2% cases. The method is simple and reliable and is recommended for practice.

摘要

525例患者采用骶管硬膜外麻醉进行下肢及盆腔器官手术。该方法的一个特点是使用含有利多卡因、0.9%氯化钠和蒸馏水的低渗局部麻醉溶液(渗透压260 mosmol/kg)。病理研究表明,成年患者至少应向骶管内注入40 ml麻醉剂以达到充分阻滞。手术过程中,骶管硬膜外麻醉能可靠地防止手术创伤,且对呼吸和循环无副作用。镇痛效果持续时间为3±0.5小时,若用镇静药物增强局部麻醉效果,镇痛时间甚至更长。未观察到并发症,5.2%的病例出现失败情况。该方法简单可靠,推荐应用于临床实践。

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