脊麻-硬膜外联合麻醉在剖宫产术中的应用体会

目的：探讨脊麻—硬膜外联合麻醉在剖宫产术中的应用。方法：对320例剖宫产病人应用脊麻—硬膜外联合麻醉情况进行回顾性分析。结果：320例病人中麻醉优良为316例，蛛网膜下腔给药后15min内麻醉平面固定，低血压发生率21％，蛛网膜下腔注入0．5％布比卡因1．2—1．8ml可获得满意的麻醉效果，蛛网膜下腔给予吗啡0．1mg可产生48h以上的镇痛效果，术后头痛4例。结论：脊麻—硬膜外联合麻醉具有作用迅速、镇痛好、肌松好、用药量少等优点，是一种理想的剖宫产手术麻醉方法。

THE USE OF COMBINED SPINAL AND EPIDURAL ANESTHESIA IN CESAREAN SECTION

Objective:To observe the clinical efficacy of combined spinal and epidural anesthesia for cesarean section.Methods:320 cases with combined spinal and epidural anesthesia for cesarean section were analyzed retrospectively.Results:316 cases had excellent effect after combined spinal and epidural anesthesia,and the anesthesia level was stable.The rate of hypotension was 21%.When 0 5% bupivacaine with a dose of 1 2 ml 1 8 ml was injected into subarachnoid space,satisfying result could be gained.When 0 1 mg of morphine was injected into subarachnoid space,the analgesic effect could last for 48 hours.4 cases had headache after operation.Conclusion:With the advantage of lower dose of drug used,combined spinal and epidural anesthesia in cesarean section has rapid effect.It also has satisfying muscle relaxing effect.In a word,combined spinal and epidural anesthesia is an ideal method for cesarean section.