CAJ | 학술논문

目的：观察蛛网膜下腔罗哌卡因注入时针缺口朝向不同对麻醉效果的影响。方法选择2014年1~7月山东中医药大学附属医院拟行下肢手术的患者40例，采用随机数字方法将其分成Ⅰ、Ⅱ组，每组各20例。Ⅰ组腰麻针缺口垂直朝向天花板，Ⅱ组腰麻针缺口水平朝向患者尾侧，两组均于蛛网膜下腔注射0.75%罗哌卡因2 mL。观察动脉压、心率、脉搏氧饱和度、镇痛起效时间、运动阻滞起效时间、给药后20 min最高痛觉阻滞平面、麻醉持续时间。并观察注药阻滞后出现的头痛、恶心、尿潴留及马尾综合征等不良反应。结果两组镇痛起效时间比较，差异无统计学意义(P>0.05)；运动阻滞起效时间，Ⅰ组长于Ⅱ组(P<0.05)；最高阻滞平面，Ⅰ组为T9，Ⅱ组为T11；麻醉持续时间，Ⅰ组较Ⅱ组短(P<0.05)；Ⅰ组术中发生恶心1例。结论腰麻针缺口的朝向不同对麻醉效果产生一定的影响；腰麻针缺口垂直朝向能获得较广范围的阻滞，但阻滞时间相应缩短；针缺口水平朝向尾侧阻滞范围相应较窄，但阻滞时间相应延长。
목적：관찰주망막하강라고잡인주입시침결구조향불동대마취효과적영향。방법선택2014년1~7월산동중의약대학부속의원의행하지수술적환자40례，채용수궤수자방법장기분성Ⅰ、Ⅱ조，매조각20례。Ⅰ조요마침결구수직조향천화판，Ⅱ조요마침결구수평조향환자미측，량조균우주망막하강주사0.75%라고잡인2 mL。관찰동맥압、심솔、맥박양포화도、진통기효시간、운동조체기효시간、급약후20 min최고통각조체평면、마취지속시간。병관찰주약조체후출현적두통、악심、뇨저류급마미종합정등불량반응。결과량조진통기효시간비교，차이무통계학의의(P>0.05)；운동조체기효시간，Ⅰ조장우Ⅱ조(P<0.05)；최고조체평면，Ⅰ조위T9，Ⅱ조위T11；마취지속시간，Ⅰ조교Ⅱ조단(P<0.05)；Ⅰ조술중발생악심1례。결론요마침결구적조향불동대마취효과산생일정적영향；요마침결구수직조향능획득교엄범위적조체，단조체시간상응축단；침결구수평조향미측조체범위상응교착，단조체시간상응연장。
Objective To observe the effect of anesthesia in the different lumbar hemp needle gap toward of injection of Ropivacaine for spinal anesthesia. Methods 40 patients with ASA lower extremity surgery from January to July 2014 in Affiliated Hospital of Shandong Traditional Chinese Medical University were selected, and they were randomly divided into group Ⅰ and group II according random number table, with 20 cases in each group. In group Ⅰ with spinal anesthesia needle gap toward kept up, group II with spinal needle gap toward kept down, and in both two groups, 0.75% Ropivacaine 2 mL were injected into the subarachnoid space. The arterial blood pressure, heart rate, pulse oxy-gen saturation, the onset time of analgesia, motor block onset time, the maximum pain block plane, duration of anesthe-sia, the emergence of other drug use or headache, nausea, urinary retention, cauda equina syndrome and other adverse reactions of two groups were observed. Results No difference was found in onset time of analgesia between two groups (P> 0.05)); in motor block onset time, group Ⅰ was longer than that of the group II (P< 0.05); in the highest block level, groupⅠ was T9, groupII was T11;in anesthesia duration, groupⅠ was more short than that of the groupII (P<0.05); 1 case nausea occurred in groupⅠ. Conclusion Lumbar hemp needle gap toward different direction produces different influence on effect of anesthesia; vertical direction of lumbar hemp needle gap to win a wide range of block but the blocking time shortened accordingly; needle hole toward the caudal blocks a narrow range corresponding, but the blocking time extended accordingly.