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 Wysłany: Pon 10:11, 21 Mar 2011 Temat postu: Combined spinal anesthesia in clinical surgery _64 |
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Combined spinal anesthesia in clinical surgery
Epidural anesthesia is more commonly used both in clinical anesthesia. But each has its shortcomings as head c after spinal anesthesia when the question is limited, the phenomenon of urinary retention can occur in some patients; and epidural anesthesia, a long incubation period, was to teach slow. Block perfect. Especially for the deeper parts of those surgical procedures, abdominal and pelvic organs with obvious traction reaction, body fat, muscle tension were, epidural block alone there will be incomplete muscle relaxation,[link widoczny dla zalogowanych], intravenous drug use can not be resolved secondary problem. This is a surgical procedure brings some difficulties. The CSEg may clamor spinal and epidural block complement their shortcomings: conventional spinal needle than rent, or because of repeated puncture dural puncture difficulties, the high incidence of headache. The spinal needle thin, and there being guided epidural needle, puncture success rate, spinal damage, easy to closed sets. Furthermore csEA set of people epidural catheter can be injected into a given volume of local anesthetic epidural space filling, which is not easy to shed subarachnoid local anesthetics can reduce postoperative headache and avoid the occurrence of all spinal anesthesia. Because spinal anesthesia can cause a range of circulatory and respiratory system changes, so in the implementation of pre-anesthesia, appropriate to add 300-500rllL Ringer's solution to prevent the occurrence of low blood pressure; the anesthesia within 5 ~ 15n, of anesthesia should be tested several times (no more than L), to prevent the intercostal muscle paralysis and respiratory depression occurs, leading to hypoxia and other symptoms. Simply maintaining spinal anesthesia time is generally 15 ~ 2h, general surgery to meet the needs of the time. If the operation time extended only an additional anesthetic in the epidural until the end of surgery, anesthetic effects without worrying about the surgery can not be completed within the time problem. In short, csEA both the glaring advantages of spinal and epidural anesthesia: anesthesia rapidly, complete block; can be repeated dosing, and to enhance the anesthetic plane as needed to extend the duration of anesthesia; a small amount of drugs can reduce the blood concentration in vivo , relatively little interference on the loop; anesthesia exactly, few complications, but also postoperative pain free. Is applicable to general surgery,[link widoczny dla zalogowanych], obstetrics and gynecology in the lower abdomen and lower limb orthopedic surgery hospitals should promote primary method of anesthesia. Received coral 1-09-12 (edited so the line) 6512 cases of thyroid subtotal hysterectomy because of complications bright ball Chen Xiaohong Xie Medical School Affiliated Hospital of Hunan Province, Shaoyang City, ear ~ 2000 Summary: To investigate the subtotal thyroidectomy Complications Causes and Prevention: Methods: A retrospective analysis 65l2 cases complications subtotal clinical data. Station Results: Common surgical complications and preoperative preparation, operative and postoperative observation station on the deal: careful and comprehensive preoperative preparation, skilled surgical operation, tight and smooth drainage of postoperative complications is to prevent the key. Key words thyroid complications of subtotal hydrazone I Hospital in June 1989 一; m00 i2 months in line with bilateral subtotal thyroidectomy 65l2 cases. Analysis of common complications and their causes will now report clinical data as a general information 1.1 6512 cases in this group of patients with primary hyperthyroidism, male 917 cases, accounting for 141%,[link widoczny dla zalogowanych], female 55 cases, 85.9%; age of 7 The shortages of 69 years under the age of 223 cases in which, 35%, 518 cases over 60 years old, accounting for 79%; course of 3 months of a 42-year-Ⅲ degree of thyroid enlargement were 2o78, accounting for 31.9%, the rest were grade Ⅱ nodes, all cases were diagnosed by pathological examination. 1.2 Ha surgical anesthesia side hit are used in this group of patients surgery using cervical plexus anesthesia = low anterior curved transverse incision, no cross-sectional anterior muscles, close to the upper pole of the thyroid gland treatment vessel; lower pole vessels,[link widoczny dla zalogowanych], well treatment from the glands on the back, if not do not affect the operation of treatment; then isolated and cut off the isthmus glands, and in pre-Ke-ping and After the capsule to retain as much as possible under the premise of the gland lateral lobe wedge resection of the majority; postoperative patients with recurrent visions cough, hold your breath. To check whether there is potential within the surgical field bleeding. Of surgery at another puncture wound below the set of a 2 cases of emergency tracheotomy, the other by the calm, pressurized suction 0 'and so remove the obstruction after 29 unilateral recurrent laryngeal nerve injury, accounting for 044% = l2 unilateral laryngeal nerve injury, accounting for 0.19% No one who had the double at the same time sad injury. 43 postoperative hematoma, accounting for 066%,[link widoczny dla zalogowanych], 1 of which occurs not in time for treatment after hemorrhagic shock, but despite the rescue of brain function is severely damaged. I re-surgery to stop bleeding and heal after surgery after a transient tic calcium Erzhi hypoparathyroidism who were I86. accounted for 28%; complicated life of an inverted calcium convulsions, accounting O.02%. No one who showed typical thyroid crisis and were followed up 15 years, 27 cases of primary A
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