The Prevention And Treatment Of Complications Of Combined Spinal Epidural Anesthesia(Clinical Analysis Of 2000 Cases)

Objective:Analyze the common complications of CSEA,discuss the prevention and treatment measures on the purpose of elevating anesthetic quality.Method:Dicuss the causetreatment and prevention measures through the retrospective analysis about the complications of 2000 CSEA cases from Shandong Provincial Hospital.Result:There are 16 cases occurred hyperplane(0.8%),2 cases occurred perforation of the spinal dural mater(0.1%),7 patients'epidural catheters entered blood vessel(0.35%), 52 cases that occurred hypotension(2.6%),2 cases occured PDPH(0.1%),1 patient occurred paranesthesia of skin of lower extremity(0.05%).There are 45 female patients who occurred complications.Complications such as hyperplane,perforation of the spinal dural mater,epidural catheters entered blood vessel,hypotension were all cured through faverouble management on time with no severe inhibition of circulation and respiration. PDPH occurred 1～3 days after operation,TNS occurred 24 hours after operation. Symptoms of PDPH and TNS disappeared in 2 days through symptomic management and exactitude observation.None of the 2000 patients had impairment of motor function or sequels.Conclusion:There were no severe complications in the 2000 CSEA clinical cases from Shandong Provincial Hospital.The main reasons are:puncture at the crevice of L3,4, used high-weight mixed liquid of low concentration 5%bupivacaine(0.75%bupicaine 2ml+ephedrin0.5ml+10%glucose 0.5 ml).On the purpose of elevating anesthetic quality anaesthetists should obey exact indications,obey operating instructions,use low concentration spinal anesthesia liquid.Cautionry medication can decrease the interference of large doses to respiration and cieculation.