The Effects Of Pre-liquid On The Epidural Catheter Insertion Intravascular In Maternal

Objective When in planned cesarean section combined spinal-epidural anesthesia, compare the prefilled 0 ml and 3 ml saline lead in the number of blood vessel before epidural catheterization、prefiled 5ml normal saline before epidural catheterization on the incidence of intravascular epidural catheter insertion and its influence on hemodynamics and anesthesia plane.Methods Selected 240 cases of ASA grade I-II,age 20 to 35 years old,height 150-170 cm,weight index <29 kg/m2, singletons full-term pregnancy,excluded spinal anesthesia contraindications, blood coagulation dysfunction, fetal distress, pregnancy complications, preeclampsia severe, twin or multiple births, planned cesarean section,according to a random number table will be divided into three groups :group A、group B、group C,80 cases in each group.Group A:before the epidural catheter into the epidural space,not given saline.Group B:3 ml saline was injected through the needle prior to catheter insertion. Group C:5 ml saline was injected in the epidural space through the needle prior to catheter insertion. The cases of epidural catheters in blood vessels were recorded respectively in group A, group B and group C.The changes in heart rate(HR),mean arterial pressure(MAP)were observed after subarachnoid drug delivery(t0), 2 min, 5 min after the treatment(t2)、(t5). Sensory block level was measured by a pinprick test at 5 and 10 minutes after injection(H5、H10).Result Group A、group B and group C in the age difference was not statistically significant, and no significant difference in terms of height, body mass index did not reach statistical significance, gestational age also too(P> 0.05). The rate of epidural catheters in blood vessels of group A was13.75%(11/80). The incidence of epidural catheters in blood vessels of group B was 7.50%(6/80). Group C epidural catheter vascular rate of 1.25%(1/80).The incidence of vascular injury in group C1.25%(1/80) was significantly lower than that in group A13.75%(11/80) and group B 7.50%(6/80)(F=7.3423,P=0.0254),The situation that catheter encountered resistance is also decreased in group C compared with group A and group B, blocked scale.There is no obvious difference between group A and group B(F=1.6454,P=0.2000). 2 min after administration of the three groups and 5 min after administration of MAP decreased compared with that before the administration, the HR levels at t0 were significantly lower than those at t2 or t5,but there were no obvious differences among the three groups. After administration of 5 min,10 min, the anesthesia plane of group B and group C were slightly higher than that of group A, but there was no statistically significant difference(P>0.05),group B and group C had no statistically significant difference(P>0.05).Conclusion Lower uterine segment cesarean section surgery, combined spinal-epidural anesthesia, 5 ml saline solution was injected in the epidural space through the needle prior to catheter insertion can not only prevent epidural catheters in blood vessels, and make insertion process more smoothly and less resistance.Can also improve the anesthesia plane and improve the effect of anesthesia.and there were no obvious effections on the mean arterial pressure and heart rate of 2min、5min after injection. After administration of 5 min, 10 min, the anesthesia plan of group B and group C slightly higher than in group A, but the difference was not statistically significant(P>0.05).The operation of combined spinal-epidural anesthesia is safe, simple, easy, induce rapid,surgical satisfaction is high, can reach the desired degree of relaxation surgery, local anesthetics can be added for easy access epidural pain pumps. Prefilled 5 ml saline in epidural space,there is on obvious effect on maternal hemodynamic, also can obviously improve the effect of anesthesia, is a very good way to prevent the epidural catheter in blood vessels, but we must pay attention to :the 5 ml saline liquid can improve beforehand about 1-2 spinal nerve block plane.