剖宫产腰硬联合麻醉选择不同穿刺点的效果观察

摘要

Objective To observe the anesthesia effect of different puncture point of combined spinal epidural anesthesia for ce-sarean section. Methods 360 patients undergoing cesarean section were divided into observation group and control group two groups in accordance with random number table. 180 cases in each group. The observation group adopted L2-3 clearance punc-ture point of spinal-epidural anesthesia, the control group adopted L3-4 gap epidural anesthesia puncture point of waist. Com-pared with anesthetic effect, onset time of anesthesia, epidural lidocaine dosage, the incidence of hypotension and adverse reac-tions of two groups. Results The excellent and good rate of anesthesia, onset time of anesthesia, epidural lidocaine dosage of the observation group was 96.67%,(3.43±1.02)min, (3.40±0.32)mL, they were obviously better than 81.67%, (8.96±2.67)min, (7.56± 1.18)mL of the control group (P<0.05). The incidence of hypotension and adverse reactions of the observation group was 28.33%, 60.56%, they were obviously higher than 15.56%, 32.78% of the control group (P<0.05). Conclusion It should be combined with individual differences and factors such as reasonable selection of patients with cesarean section combined spinal epidural anesthe-sia puncture point.%目的：观察剖宫产腰硬联合麻醉选择不同穿刺点的麻醉效果。方法选择拟行剖宫产孕妇360例，按随机数表法分为观察组与对照组，各180例。观察组采取L2-3间隙为穿刺点进行腰硬联合麻醉，对照组采取L3-4间隙为穿刺点，比较两组的麻醉效果、起效时间、硬膜外利多卡因用量、低血压发生率及不良反应发生率。结果观察组麻醉优良率、起效时间、硬膜外利多卡因用量分别为96.67%、（3.43±1.02）min、（3.40±0.32）mL，明显优于对照组的81.67%、（8.96±2.67）min、（7.56±1.18）mL（P＜0.05）；观察组低血压发生率、不良反应发生率分别为28.33%、60.56%，明显高于对照组的15.56%、32.78%（P＜0.05）。结论应结合患者个体差异及病情等因素合理选择行剖宫产的腰硬联合麻醉穿刺点。