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February 14, 2005

エピ考(2)

産婦人科医は,全麻はしないけどエピとルンバールは毎日のように自分でしていることが多いらしく,エピには自信があるようだ。私がエピを入れているとき,背後から食い入るように見つめているのはほとんどが産婦人科医だ。なかには「俺のほうがこの麻酔科医よりエピは上手だ」と思っている産婦人科医も多いだろう。しかし,私は声を大にして言いたい。LとThでは難易度が違うのだ。
しかし,彼らがよく入れているL2/3あたりのエピが婦人科の術後鎮痛に有効なのだろうか?
もし有効なら,Th9/10などから入れる必要はないということになる。

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Comments

体験談として 
私は2回の出産どちらもカイザーでした.1回目は産婦人科医がエピを入れてくれましたが,術後太ももばかりがしびれて傷が痛くて「何だこれは!L1−2に効いてるじゃん!」ともだえてしまいました. 
やはり, 下腹部の手術でも術後鎮痛に使うなら,皮切に合わせないと意味がないと体験的に知りました.
後日そこの施設で働くようになり,そこの若手産婦人科医の麻酔研修の手伝いをした私は,その情報を産婦人科にも還元しました.

Posted by: ゆんじゅん | July 12, 2005 at 05:00 PM

ギネの手術(全麻+エピ)の保険審査で,「下腹部の手術なのに“胸部”硬膜外はおかしい」という理由でエピが削られた(腰部硬膜外に減点)という話を聞いたことがあります。

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