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題名 | Caudal Epidural Block for Minor Gynecologic Procedures in Outpatient Surgery=尾椎硬脊膜外腔神經阻斷術應用於門診簡易婦科的手術 |
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作者 | 黃樹欽; 李俊毅; 陳捷; 曾紀浩; 劉雪金; 蔡時彰; 高宜娟; 黃潔文; Wong, Shu-yam; Li, Jihn-yih; Chen, Chit; Tseng, Chi-hao; Liou, Shiue-chin; Tsai, Shih-chang; Kau, Yi-chuan; Wong, Kit-man; |
期刊 | 長庚醫學 |
出版日期 | 20040200 |
卷期 | 27:2 2004.02[民93.02] |
頁次 | 頁116-121 |
分類號 | 416.5 |
語文 | eng |
關鍵詞 | 尾椎硬脊膜外腔神經阻斷術; 簡易婦科手術; Caudal epidural block; Minor gynecologic procedures; |
中文摘要 | 背景:近年來尾椎硬脊膜外腔神經阻斷術應用於兒科止痛上漸趨重要性,可是有關成人門診手術使用此法的資料卻相當少。我們的目的就是要提出簡易婦科手術(MGP)可使用此種簡單、安全符合經濟原則的麻醉方式。 方式:172位女性患者接受此研究,每位患者皆注射20毫升單劑量尾椎硬脊膜外腔1.5% lidocaine(沒有添加劑)。尾椎硬脊膜神經阻斷術(CEB)的效能予以評估。手術種類及時間、麻醉成功率、麻醉高度、尾椎針穿刺深度、副作用及恢復室停留時間皆為本文所探討的範圍。 結果:本研究並沒有任何副作用產生且病患血動力狀況變化微少。所有手術病患皆有不錯的止痛作用;但7位需增加止痛劑(失敗率為4.1%);然而成功率卻高達95.9%(165/172);麻醉及手術所需時間分別為46.66±11.76及23.08±9.54分鐘。麻醉最高可達T10之感覺範圍;尾椎硬脊膜穿刺深度為3.06±023公分;術後只有3位需用止痛劑;4位出院前可自解小便;本研究沒有使用任何止吐劑,恢復室停留時間為74.30±10.80分鐘。 結論:使用1.5% lidocaine之20毫升單劑量(CEB)於(MGP)的病患,被認為是一種安全、簡單的麻醉方法;它能提供MGP滿意的麻醉且病人不會延遲出院時間。對於此類病患,CEB可以作為另一種不同麻醉方式的選擇,使用於臨床麻醉上。 |
英文摘要 | Background: Caudal epidural block (CEB) has become increasingly important for pediatric analgesia in recent years. However, data regarding CEB in adult ambulatory surgery are scarce. The aim of this study was to verify whether CEB could be applied as a simple, safe and economic method of anesthesia for adult patients undergoing minor gynecologic procedures (MGP). Methods: One hundred and seventy-two female patients were enrolled in this study. Each patient received a 20-mL bolus of 1.5% lidocaine caudal epidural injection. The efficacy of CEB was evaluated. Types and duration of surgery, success rate, sensory level of analgesia, caudal epidural depth, complications and duration in the postanesthesia care unit (PACU) were also under investigation. Results: No side effects occurred and only few hemodynamic changes were noted in the study. All patients experienced excellent surgical anesthesia except seven patients, who required rescue supplement opioids (4.1% of failure rate). The success rate of CEB was 95.9% (165/172). Duration of anesthesia and surgery were 46.66±11.76 min and 23.08±9.54 min, respectively. The hgighest sensory dematome level reached below T10. The average epidural depth was 3.06±0.23 cm. No postoperative anti-emetic was given in the study. Only three patients required postoperative narcotics. Four patients had spontaneous voiding before discharge. The average PACU stay was 74.30±10.80 min. Conclusion: Single-dose CEB with 1.5% lidocaine 20-mL was an easy and simple technique. It provided satisfactory anesthesia for MGP and did not prolong patients’ discharge time. CEB may be another choice of anesthetic technique in such cases of clinical practice. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。