【罂粟摘要】腰部硬脊膜囊的解剖尺寸可预测分娩期间持续硬膜外镇痛的感觉阻滞效果

2021
11/09

+
分享
评论
罂粟花
A-
A+

DSL和BMI可作为连续硬膜外分娩镇痛过程中感觉阻滞峰值水平的预测指标。

关注罂粟花,共同学习麻醉学最新文献

硬脊膜囊的解剖尺寸预测分娩期间持续硬膜外镇痛的感觉阻滞效果

   

13031636436559511

贵州医科大学  麻醉与心脏电生理课题组

翻译:张中伟  编辑:张中伟  审校:曹莹

>>>   背景  

      腰部硬脊膜囊的解剖尺寸决定了蛛网膜下腔麻醉的感觉阻滞效果;然而,在持续硬膜外麻醉(CEA)期间,它是否具有相同的预测价值目前尚不确定。我们设计本研究的目的是验证腰部硬脊膜囊的解剖尺寸在预测分娩镇痛期间的感觉阻滞水平中具有有效性。

>>>   方法  

      本研究纳入122名要求分娩镇痛的单胎妊娠产妇。用彩色多普勒超声诊断仪测量腰部硬脊膜囊直径(DSD)、硬脊膜囊长度(DSL)、硬脊膜囊表面积(DSA)和硬脊膜囊体积(DSV)。硬膜外麻醉在L2-L3间隙进行。硬膜外置管后,连接含有0.08%罗哌卡因和0.4μg/ml舒芬太尼的电子输注泵。用酒精浸泡过的棉花、棉签或针刺法测定感觉阻滞效果。用视觉模拟量表(VAS)测定CEA的镇痛效果。将产妇分为“理想镇痛”组和“非理想镇痛”组,两组采用t检验进行比较。皮尔逊相关分析用于评估腰部硬脊膜囊的解剖尺寸与感觉阻滞效果之间的关系。多元线性回归分析用于建立预测感觉阻滞效果的模型。

>>>   结果  

       理想镇痛组患者的身高、DSL、DSA、DSV、DSD均较小,体重指数(BMI)显著较大(P<0.05)。此外,硬脊膜囊长度(DSL)与镇痛峰值水平(r=−0.816, P<0.0001),温感觉阻滞效果(r=−0.874, P<0.0001)和触觉阻滞效果(r=−0.727, P<0.0001)的相关性最强。最后,多元线性回归分析显示,DSL和BMI有助于预测感觉阻滞峰值水平。

695616364365598164005163643656004559571636436560182

>>>   结论  

        综上所述,我们的研究表明,当产妇的DSL、DSA、DSV和DSD数值较小时,CEA的感觉阻滞效果较好。DSL和BMI可作为连续硬膜外分娩镇痛过程中感觉阻滞峰值水平的预测指标。

>>>   原始文献来源  

            Chenyang Xu, Can Liu, Xiaoju Jin, et al. Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor.[J]. BMC Anesthesiol(2021) 21:268:1


Anatomical dimensions of the lumbar

dural sac predict the sensory block level

of continuous epidural analgesia during labor

Abstract

Background: The anatomical dimensions of the lumbar dural sac determine the sensory block level of spinal anesthesia; however, whether they show the same predictive value during continuous epidural anesthesia (CEA) remains undetermined. We designed the present study to verify the efficacy of the anatomical dimensions of the lumbar dural sac in predicting the sensory block level during labor analgesia.

Method:A total of 122 parturients with singleton pregnancies requesting labor analgesia were included in this study. The lumbar dural sac diameter (DSD), lumbar dural sac length (DSL), lumbar dural sac surface area (DSA), and lumbar dural sac volume (DSV) were measured with an ultrasound color Doppler diagnostic apparatus. CEA was performed at the L2‑L3 interspace. After epidural cannulation, an electronic infusion pump containing 0.08% ropivacaine and sufentanil 0.4 μg/ml was connected. The sensory block level was determined with alcohol‑soaked cotton, a cotton swab, and a pinprick. The analgesic efficacy of CEA was determined with a visual analog scale (VAS). The parturients were divided into two groups, “ideal analgesia” and “nonideal analgesia, ” and the groups were compared by t test. Pearson’s correlation was performed to evaluate the association between the anatomical dimensions of the lumbar dural sac and sensory block level. Multiple linear regression analysis was used to create a model for predicting the sensory block level.

Results:In the ideal analgesia group, the height, DSL, DSA, DSV and DSD were significantly smaller, and the body mass index (BMI) was significantly larger (P<0.05). In addition, the DSL demonstrated the strongest correlation with the peak level of pain block (r =−0.816,  P<0.0001; Fig. 2A), temperature block (r =−0.874,  P<0.0001; Fig. 3A) and tactile block (r =−0.727,  P<0.0001; Fig. 4A). Finally, the multiple linear regression analysis revealed that DSL and BMI contributed to predicting the peak sensory block level.

Conclusion:In conclusion, our study shows that the sensory block level of CEA is higher when the DSL, DSA, DSV and DSD of puerperae are lower. DSL and BMI can be treated as predictors of the peak sensory block level in CEA during labor analgesia.

本文由“健康号”用户上传、授权发布,以上内容(含文字、图片、视频)不代表健康界立场。“健康号”系信息发布平台,仅提供信息存储服务,如有转载、侵权等任何问题,请联系健康界(jkh@hmkx.cn)处理。
关键词:
感觉,硬膜外,效果,阻滞,腰部

人点赞

收藏

人收藏

打赏

打赏

我有话说

0条评论

0/500

评论字数超出限制

表情
评论

为你推荐

推荐课程


社群

精彩视频

您的申请提交成功

确定 取消
剩余5
×

打赏金额

认可我就打赏我~

1元 5元 10元 20元 50元 其它

打赏

打赏作者

认可我就打赏我~

×

扫描二维码

立即打赏给Ta吧!

温馨提示:仅支持微信支付!