脑脊液流速对腰麻和硬脊膜外联合麻醉效果的影响

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Abstract Objective To explore the influence of different cerebrospinal fluid flow rates on the effectiveness of combined spinal-epidural anesthesia.Methods Two hundred patients undergoing anterior cruciate ligaments (ACL) of knee joint reconstruction with arthroscopy were selected and randomly divided into two groups: group A in which the cerebrospinal fluid flow rate of patients was less than 5 s (n=100) and group B in which the flow rate was above 10 s (n=100). Both groups received combined spinal-epidural anesthesia with 0.5% ropivacain 3 ml, which was diluted with 0.9% normal saline 1 ml.The injection speed was 0.1 ml/s in both groups. Anesthesia was maintained with epidural administration with 2% lidocaine if necessary during operation.Results In group A, the onset of pain block to T8 was earlier than in group B, which was(9.16±0.41) vs (11.97±0.44)min (P<0.05), while the onset time of the highest analgesia plane was(11.12±0.23)vs(15.24±0.22)min (P<0.05).There was no statistically significant difference between the two groups according to the Bromage score for motor block. The effect of tourniquets was excellent in 99% of the cases in group A, which was better than in group B (87%) (P<0.05).Conclusions The cerebrospinal fluid flow rate has much influence on the anesthesia plane and anesthetic effect. A cerebrospinal fluid velocity below 5 s and an injection speed of 0.1ml/s with 0.5% ropivacaine can yield satisfactory anesthetic effect. Anesthesiologists should adjust the drug injection rate according to the cerebrospinal fluid velocity in order to achieve the optimal anesthetic effect.

Key words： anterior cruciate ligament combined spinal epidural anesthesia 0.5% ropivacain flow rate of cerebrospinal fluid anesthetic effect adverse reactions

Received: 10 March 2018

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	Articles by authors
	ZHANG Qianlong
	QI Lijie
	LI Shengnan
	and DONG Lan

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ZHANG Qianlong,QI Lijie,LI Shengnan等. Influence of different cerebrospinal fluid flow rates on the effectiveness of combined spinal-epidural anesthesia[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(7): 663-662.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2018/V29/I7/663

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