【摘要】 目的观察胸腰部脊椎骨折手术患者硬膜外阻滞的效果与安全性。方法49例胸腰部脊椎骨折手术患者,ASA I~II级,以1.0%~1.3%利多卡因行硬膜外阻滞,俯卧位下行内固定手术。按脊椎骨折部位分组,腰椎部骨折手术28例(简称腰椎组),胸椎部骨折手术21例(简称胸椎组)。记录硬膜外阻滞的麻醉效果,术中监测心率、血压、呼吸频率、动脉血氧饱和度等,5 m in记录1次。结果手术时间、出血量、呼吸循环变化等2组比较均无显著性差异(P>0.05)。腰椎组麻醉平面为T6~8至L3~5,麻醉效果优良率92.9%;胸椎组麻醉平面T1~6至T10~L2,麻醉效果优良率38.1%,2组麻醉效果优良率有统计学意义(P<0.01)。结论俯卧位下脊椎骨折内固手术中硬膜外阻滞用于腰椎部手术的病例麻醉效果较好、安全性较高。更多还原

【Abstract】 Objective To observe the effect and safety of epidural anesthesia in operation for patients with thoracolumbar fractures.Methods The epidural anesthesia with 1.0%～1.3% lidocaine was performed in internal fixation operation by prone position in 49 patients with thoracolumbar fractures,in which physical grades were I～II grade.Among 49 patients,the lumbar fracture was 28 patients and thoracic vertebral fracture was 21 patients.The anaesthetic effectin in operation was recorded,and the heart rate,blood pressure,respiratory rate and arterial oxygen saturation were monitored every 5 min.Results There was no significant difference in oporative time,hemorrhagic,quantity change of breath and circulation between two groups.The anesthetic level was t_6⁸ to L_3⁵ and the rate of excellent and good outcomes was 92.9% in group of lumbar fracture.The anes the tic level was T_1⁶ to T₁₀^L₂ and the rate of excellent and good out come was 38.1% in group of thoracic fracture.Conclusion Epidural anaesthesia is effective and safe for operative paients with lumbar fracture undergone internal fixation operation by prone position.更多还原