硬膜外麻醉在硬膜外腔灌洗下PELD手术中的应用

发表时间：2015-04-07 浏览次数：1164次

引用：

柳胜安,许常娥,潘晨晨等.硬膜外麻醉在硬膜外腔灌洗下PELD手术中的应用[J].吉林医学,2014,(19):4230-4232

关键词：

作者：

柳胜安1，许常娥2，潘晨晨1，王兰兰1，孙运乾1，阮加萍1，李青1，刘向荣1 ，茆庆洪1

作者单位：

.江苏省中西医结合医院麻醉科，江苏南京210028；2.江苏省南京市浦口医院麻醉科，江苏南京210

出版年份：

2014

期刊页数：

4230-4232

收录者：

知网,万方

摘要：

目的：总结硬膜外麻醉用于PELD手术的临床可靠性和安全性。方法：回顾4年来284例PELD手术选择不同硬膜外麻醉方法下的麻醉效果和术中并发症。结果：回顾的样本中，所有硬膜外麻醉均可满足手术基本无痛要求，硬膜外麻醉穿刺点选择T12~L1或T11~T 12能较好地保留手术目标区域的神经根和硬膜囊对器械刺激产生胀痛感，并保证手术其他操作无疼痛感。结论：硬膜外麻醉可以作为PELD手术较好的麻醉选择，但要控制足侧感觉平面不低于L3~L4，并选择低浓度罗哌卡因多次小剂量给药方式诱导，术中不可追加麻醉药，无需静脉辅助镇静与镇痛。 Abstract：Objective To summarize clinical reliability and security of epidural anesthesia for PELD. Method〖KG*2〗We reviewed anesthetic effect and side effects of 284 cases who received operation of PELD under different epidural anesthesia in last four years.ResultsIn these cases，we found epidural anesthesia which met requirements of PELD.Selecting T12-L1 or T11-T12 as epidural puncture pointwas recommended by us，and the obtained blocking area could spare surgery of the target area on the nerve root and dural stimulation devices sense of pain，andensure that other surgical operations without pain.ConclusionEpidural anesthesia can be as a good choice for PELD.However，the anesthetic plane shoud be controled over L3～L4.and chooselow concentrations of ropivacaine administration induced multiple small doses.Donot superaddition with Local anesthetics in operation.Intravenous sedation and nalgesia auxiliary is not needed.

阅读全文