摘要
目的探讨超声引导下股神经结合侧入路腘窝坐骨神经阻滞在膝关节镜手术中的麻醉效果。方法选取资中县人民医院2015年2月—2017年3月收治的行膝关节镜手术患者120例,随机分为股神经-坐骨神经阻滞组(A组)、腰丛-坐骨神经阻滞组(B组)及硬膜外麻醉组(C组),各40例。A组患者采用超声引导下股神经结合侧入路腘窝坐骨神经阻滞,B组患者采用超声引导下腰丛-坐骨神经阻滞,C组患者采用连续硬膜外麻醉。比较3组患者麻醉持续时间[麻醉时间(Ta)、感觉神经阻滞起效时间(Tb)、完善时间(Tc)、持续时间(Td)及运动神经组织起效时间(Te)、完善时间(Tf)、持续时间(Tg)]及麻醉前(T_0)、麻醉后15min(T_1)、麻醉后30min(T_2)及麻醉后60min(T_3)时的平均动脉压(MAP)、心率(HR)、麻醉效果,观察3组患者不良反应发生情况。结果 B组患者Ta长于A组、C组(P<0.05)。C组患者Tb、Td短于A组、B组,Te、Tg长于A组、B组(P<0.05)。T_1、T_2、T_3时,C组MAP水平低于A组、B组(P<0.05)。3组患者不同时间点HR水平、麻醉效果比较,差异无统计学意义(P>0.05)。C组患者不良反应发生率高于A组、B组(P<0.05)。结论超声引导下股神经结合侧入路腘窝坐骨神经阻滞在膝关节镜手术中的麻醉效果确切,其麻醉效果理想,且安全性更高。
Objective To discuss the anesthesia effect of ultrasound-guided femoral nerve combined with lateral popliteal sciatic nerve block in laparoscopic surgery.Methods A total of120cases of patients with laparoscopic surgery were selected from February2015to March2017in Zizhong County People's Hospital,which were randomly divided into A group,B group and C group,40cases in each group.A group was given ultrasound-guided femoral nerve combined with lateral popliteal sciatic nerve block,B group was given ultrasound-guided lumbar plexus-sciatic nerve block,C group was given continuous epidural anesthesia.The anesthesia duration[anesthesia time(Ta),onset time of sensory nerve block(Tb),perfect time(Tc),duration time(Td)and onset time of motor nerve block(Te),perfect time(Tf),duration time(Tg)],MAP and HR before anesthesia(T0),after anesthesia of15min(T1),after anesthesia of30min(T2),after anesthesia of60min(T3),and anesthesia effect were compared among three groups.Results The B group of Ta was longer than A,C group(P<0.05).C group of Tb,Td were shorter than A,B group,Te,Tg were longer than A,B group(P<0.05).At T1,T2,T3,C group of MAP was lower than A,B group(P<0.05).No significant differencesof HR or anesthesia effect was found among three groups(P>0.05).The incidence rate of adverse reactions was higher than A,B group(P<0.05).Conclusion Ultrasound-guided femoral nerve combined with lateral popliteal sciatic nerve block have an exactly clinical effect in laparoscopic surgery,with a ideal effect and higher safety.
作者
王育东
WANG Yu-dong(Department of Anesthesiology,Zizhong County People 's Hospital,Zizhong 641200,China)
出处
《实用心脑肺血管病杂志》
2017年第B12期25-27,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
膝关节镜手术
股神经
坐骨神经
神经阻滞
麻醉
Laparoscopic surgery
Femoral nerve
Sciatic nerve
Nerve block
Anesthesia
