摘要
目的分析改良骶管阻滞的麻醉效果。方法 3681例行改良骶管阻滞的患者,俯卧或侧卧位下用带7号针头的5ml注射器穿刺,突破骶尾韧带,回抽无血液无脑脊液,注药阻力小,患者局部或放射状酸麻胀感,皮下无气肿即可判断为穿刺成功,一次性注入1%利多卡因15～20ml及0.375%～0.5%罗哌卡因5～10ml,总量约25ml,记录麻醉平面、麻醉效果分级等,常规监测血压(BP)、脉搏(P)、脉搏血氧饱和度(SpO2)、呼吸频率(RR)、心电图(ECG)等,咪达唑仑镇静至RamsayⅢ～Ⅳ级。结果麻醉效果达Ⅰ级者2869例(77.94%)、Ⅱ级者597例(16.22%),共3466例,总成功率为94.16%;轻度局麻药毒性反应反应176例(4.78%)。结论改良骶管阻滞麻醉效果确切,不良反应少,可作为肛肠手术的首选麻醉方法。
Objective To analyze the anesthesia effect of modified caudal block for anorectal surgery. Methods 3681 caudal block patients were positioned prone or side. They were punctured with 5 ml syringe with 7 syringe needle to break through the sacrococcygeal ligament. Successful puncture could be regarded only when no blood and cerebrospinal fluid could be withdrawn, the resistance to injection was low, having partial or radial sore sense and no subcutaneous em- physema could be detected. Then, patients were infused for 1% lidocaine 15-20 ml and 0.375%-0.5% ropivacaine 5- 10 ml, ±25 ml in total. Level of anesthesia and grade of anesthetic effect were recorded. The BP, P, SpO2, RR, ECG and other vital signs were monitored routinely, midazolam was used to help sedation to Ramsay Ⅲ～Ⅳ level. Results 2869 cases （77.94%） received anesthetic effect level Ⅰ and 597 cases （16.22%） received anesthetic effect level Ⅱ. And 3466 cases in total received the successful rate of 94.16%. 176 cases with mild local anesthetic toxicity （4.78%）. Conclusions Anesthesia effect of modified caudal block is good and with few adverse reactions. This procedure can be used as the first anesthetic choice for anorectal surgery.
出处
《北京医学》
CAS
2012年第8期699-701,共3页
Beijing Medical Journal
关键词
骶管阻滞
改良
肛肠手术
麻醉
Caudal block
Improving
Anorectal surgery
Anesthesia
作者简介
通讯作者
