摘要
目的:探讨神经刺激器下腰丛联合坐骨神经阻滞对膝关节镜手术麻醉效果的影响。方法:将我院自2010年3月至2013年3月收治的86例需要采用膝关节镜手术的患者以数字法随机分成观察组(43例)和对照组(43例)。观察组采用在神经刺激器下腰丛联合坐骨神经阻滞下进行膝关节镜手术;对照组采用腰硬联合麻醉下进行膝关节镜手术。记录并对比两组不同方案麻醉后的血流动力学、麻醉效果、起效维持时间、补液量以及不良反应。结果:对照组麻醉准备和操作的时间(Tr)、感觉完全阻滞的时间(T1)、感觉恢复的时间(T2)、运动完全阻滞的时间(T3)、运动恢复的时间(T4)显著少于观察组(P<0.05),对照组手术后第1次排尿的时间(Tu)显著长于观察组(P<0.05);与麻醉前比较,对照组麻醉之后5 min(T5)、20 min(T20)平均动脉压下降,T20时对照组平均动脉压低于观察组(P<0.05)。并发症的发生对照组明显多于观察组。结论:神经刺激器下腰丛联合坐骨神经阻滞对膝关节镜手术麻醉的临床效果更明显,特别是手术时间相对较长的患者更适合采用此方案。
Objective To study the clinical effect of nerve stimulator combined with low back piexus sciatic nerve block for the arthroscopic surgery anesthesia. Methods 86 patients who required the arthroscopic surgery from March 2010 to March 2013 in our hospital were randomly divided into observation group （43 cases） and control group （43 cases）. The observation group accepted nerve stimulator combined with low back plexus sciatic nerve block under the arthroscopic surgery;the control group adopted waist hard joint anesthesia during the arthroscopic surgery. Data of hemodynamics, effects of anesthesia, anesthesias maintaining time, rehydration fluids and adverse effect in both groups were recorded and compared. Results The time for preparation and control of anesthesia operation （Tr）, time for feeling completely block （TI）, time for recovery （T2）, time for completely blocking （T3）, time for movement recovery （T4） in observation group were significantly shorter than that of the observation group （P 〈 0.05） ; the first time of urination （Tu） after operation was significantly longer in control group than that in the observation group （P 〈 0.05）; MAP in the control group were lower than that in the observation group 20 minutes after anesthesia （T20,P 〈 0.05） ; complications in the control group were more frequent than that in the observation group. Conclusion The clinical effect of nerve stimulator combined with low back plexus sciatic nerve block for the arthroscopic surgery anesthesia is more obvious, especially for patients with relatively long operating time.
出处
《实用医学杂志》
CAS
北大核心
2014年第19期3076-3078,共3页
The Journal of Practical Medicine
基金
吴阶平医学基金会临床科研专项资助基金课题(编号:2011-427-2107)
关键词
神经刺激器
腰丛联合坐骨神经阻滞
膝关节镜手术
麻醉效果
临床效果
Nerve stimulation
Lumbar plexus combined with sciatic nerve block
Arthroscopic surgery
Anesthesia effect
Clinical effect
