摘要
目的:分析超声引导下腘窝入路坐骨神经联合隐神经阻滞麻醉在糖尿病足软组织切开清创引流中的应用。方法:选取2018年10月-2020年9月厦门市第五医院收治的86例糖尿病足患者。按照随机数字表法将其分为观察组和对照组,每组43例。对照组给予蛛网膜下腔阻滞麻醉,观察组给予超声引导下腘窝入路坐骨神经联合隐神经阻滞麻醉。观察两组术前,术后12、24 h疼痛情况及麻醉效果。观察两组麻醉前及麻醉后5、10、15、30 min收缩压、舒张压、心率。比较两组术后并发症及麻醉不良反应。结果:术后12、24 h,观察组疼痛数字评分法(NRS)评分均明显低于对照组(P<0.05)。观察组运动及感觉神经起效时间均早于对照组(P<0.05),持续时间长于对照组(P<0.05)。对照组麻醉后5、10、15、30 min收缩压、舒张压均较麻醉前下降(P<0.05),观察组麻醉后5、10、15、30 min收缩压、舒张压均高于观察组(P<0.05)。观察组麻醉后5、15 min心率高于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(χ~2=2.048,P=0.247)。观察组麻醉不良反应发生率低于对照组(P<0.05)。结论:超声引导下腘窝入路坐骨神经联合隐神经阻滞麻醉效果较好,可以有效稳定生命体征,减轻疼痛。
Objective:To analyze the application of ultrasound-guided popliteal fossa approach sciatic nerve combined with saphenous nerve block anesthesia in diabetes foot soft tissue incision debridement and drainage.Method:A total of 86 patients with diabetic foot admitted to Xiamen Fifth Hospital from October 2018 to September 2020 were selected.According to the random number table method,they were divided into observation group and control group,with 43 cases in each group.The control group was given subarachnoid anesthesia,and the observation group was given ultrasound-guided popliteal fossa approach sciatic nerve combined with saphenous nerve block anesthesia.The pain condition before operation,12,24 h after operation and anesthetic effect of the two groups were observed.Systolic blood pressure,diastolic blood pressure and heart rate were observed before anesthesia and 5,10,15,30 min after anesthesia in the two groups.The postoperative complications and adverse reactions of anesthesia were compared between the two groups.Result:At 12 and 24 h after operation,the numeric rating scales (NRS) score of the observation group was significantly lower than that of the control group (P<0.05).The onset time of motor and sensory nerves in the observation group were earlier than those in the control group (P<0.05),and the duration was longer than that in the control group (P<0.05).The systolic and diastolic blood pressure of the control group at 5,10,15 and 30 minutes after anesthesia were lower than those before anesthesia (P<0.05).The systolic and diastolic blood pressure of the observation group at 5,10,15 and 30 minutes after anesthesia were higher than those of the control group (P<0.05).The heart rate of the observation group was higher than that of the control group at 5 and 15 minutes after anesthesia (P<0.05).There was no significant difference in the incidence of complications between the two groups (χ~2=2.048,P=0.247).The incidence of adverse reactions of anethesia in the observation group was lower than that in the control group (P<0.05).Conclusion:Ultrasound-guided popliteal fossa approach sciatic nerve combined with saphenous nerve block anesthesia has a good effect,which can effectively stabilize vital signs and reduce pain.
作者
冯冲冲
苑继侠
饶荣
王凯
FENG Chongchong;YUAN Jixia;RAO Rong;WANG Kai(Xiamen Fifth Hospital,Xiamen 361101,China)
出处
《中外医学研究》
2022年第30期5-9,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
神经阻滞麻醉
蛛网膜下腔麻醉
糖尿病足
血压
疼痛
Nerve block anesthesia
Subarachnoid anesthesia
Diabetic foot
Blood pressure
Pain
