摘要
目的评估超声引导下腰骶丛联合T12/L1椎旁神经阻滞在全髋关节置换术中的临床应用价值。方法择期行单侧全髋关节置换术病人61例,所有病人均采用超声引导下腰骶丛联合T12/L1椎旁神经阻滞,记录病人围术期情况、注药后30分钟感觉阻滞平面、阻滞前后血流动力学变化、手术麻醉效果及神经阻滞相关并发症发生情况。结果注药后30分钟,T12~S3支配皮区针刺感觉阻滞成功率为87.0%~100%。阻滞后平均动脉压及心率与阻滞前比较,差异无统计学意义(P>0.05)。总体手术麻醉优良率为97.0%,61例病人发生1例双侧阻滞。结论超声引导下腰骶丛联合T12/L1椎旁神经阻滞用于全髋关节置换手术,血流动力学平稳,镇痛效果确切,阻滞效果更优。
Objective To evaluate the safety and efficacy of ultrasound guided lumbosacral plexus and T12/L1 paravertebral block for hip arthroplasty. Methods We retrospectively analyzed the perioperative data of 61 patients scheduled for elective hip arthroplasty surgery. These patients all received ultrasound-guided lumbosacral plexus and T12/L1 paravertebral block. We recorded effect of sensory block after 30 min of 0. 4% ropivacaine injection,hemodynamic parameters,analgesic quality and adverse events related to nerve block. Results The success rates of sensory blockade of pinprick for the dermatomes T12-S3 were from 87% to 100%,with 97% success rates meeting the need of surgical analgesia. Compared with the baseline,there was no significance in mean arterial pressure and heart rate after the block（ P 0. 05）. Bilateral spread occurred in one patient. Conclusion Ultrasound guided lumbosacral plexus and T12/L1 paravertebral block is a safe and effective technique in hip joint replacement surgery for elderly patients with multiple comorbidities. This pattern of anesthesia can provide stable hemodynamics,enough range of sensory blockade and good surgical analgesia for hip arthroplasty.
出处
《临床外科杂志》
2017年第8期634-637,共4页
Journal of Clinical Surgery
基金
湖北省卫生计生委青年人才资助项目(WJ2015Q008)
贝朗基金资助项目(2015020)
关键词
腰骶丛
椎旁
全髋关节置换术
lumbosacral plexus
paravertebral
hip arthroplasty
