Objective To study the effect of simultaneous injection of physiological saline during epidural catheterizating on epidural catheterization at obstetric anesthesia and investigate the possibility of its application in obstetric anesthesia. Methods Three hundred cases scheduled for low-segment cesarean section under combined spinal epidural anesthesia ( CSEA ) were randomly divided into two groups: control group ( n = 150 ) with epidural catheterization by conventional methods, and experimental group ( n = 150 ) receiving injection of physiological saline through epidural catheter while epidural catheterizating. The level of anesthesia 15 minutes after spinal anesthesia and the incidence of inadvertant venous puncture as well as paresthesia and failure in epidural catheterization were observed. Results Compared with the control group, the experimental group had fewer cases with inadequate level of anesthesia 15 minutes after spinal anesthesia (5.3% vs 12.7% ) and lower incidence of inadvertent venous puncture ( 4. 0% vs 14. 0% ) as well as failure in epidural catheterization ( 2.7% vs 10.7% ). There were significant differences (χ2 value was 9. 158 and 7. 714, respectively, both P < 0. 05 ). Conclusion Simultaneous injection of physiological saline during epidural catheterizating can elevate the success rate of epidural catheterization during obstetric anesthesia. It is worth to promote the application widely in obstetric anesthesia.%目的 研究硬膜外腔置管同时注入生理盐水对产科麻醉硬膜外置管的影响,探讨其在产科椎管内麻醉中的应用.方法 300例拟于腰硬联合麻醉下行择期子宫下段剖宫产患者,随机分为两组,对照组(n=150)使用常规方法硬膜外置管,实验组(n=150)于硬膜外腔置管同时经硬膜外导管注入生理盐水,观察腰麻注药后15min麻醉平面及硬膜外腔置管置入血管、置管异感、置管失败的发生率.结果 与对照组相比,实验组腰麻注药后15min,麻醉平面过低者较少(5.3% vs 12.7%),置入血管(4.0%vs 14.0%)、置管失败(2.7% vs 10.7%)的发生率明显低于对照组,差异均具有统计学意义(χ2值分别为9.158和7.714,均P<0.05).结论 硬膜外腔置管同时注入生理盐水,可提高麻醉时硬膜外腔置管成功率,值得在产科麻醉中广泛推广应用.
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