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既往所用的硬膜外导管法有在产程中需变换体位,药量大,屏气反射消失,易宫缩乏力,从而增加了胎头吸引术等缺点。此外常用的丁哌卡因(bupivacaine)易通过胎盘,现正在试验减少药量中。近年有人在腰部、骶部分别插入硬膜外导管(双管法)以达到减少药量的目的。由于妊娠期皮下脂肪丰富,腰背不易充分屈曲,椎间隙不能充分开大,硬膜外腔静脉丛怒张等因素,增加了操作的困难且并发症倍增。本文报道用一根双孔式硬膜外导管(双腔导管)(见附图),对初产妇7例,经产妇10例,于孕37～40周应用于计划分娩。结果成功地达到了减少药量,分娩过程无痛的目的,而且安全可靠。
Past epidural catheter used in the labor process need to change body position, large dose, breath-hold reflex, easy to uterine inertia, thereby increasing the fetal head suction and other shortcomings. In addition, commonly used bupivacaine (bupivacaine) easily through the placenta, is now under trial to reduce the dose. In recent years, some people in the waist, sacral were inserted into the epidural catheter (double tube method) in order to achieve the purpose of reducing the dose. Because of subcutaneous fat during pregnancy rich, not easy to fully flexion of the lower back, the disc space can not be fully open large, epidural venous plexus and other factors, increasing the difficulty of operation and double the complication. This article reports the use of a dual-hole epidural catheter (double lumen catheter) (see photo), 7 cases of primipara, 10 cases of maternal, at 37 to 40 weeks of pregnancy for scheduled delivery. The results achieved successfully reduce the dose, labor painless purpose, and safe and reliable.