神经刺激器辅助下腰丛联合坐骨神经阻滞与腰硬联合麻醉在膝关节镜手术麻醉的效果比较.docVIP

神经刺激器辅助下腰丛坐骨神经阻滞与腰麻在手术麻醉的效果比较 章 蔚 方 才 谢言虎 [摘 要] 目的 比较神经刺激器辅助下腰丛坐骨神经阻滞与腰麻在手术的麻醉效果。方法 60例手术患者随机分为腰组（组）和腰丛联合坐骨神经阻滞组（N组）两组，每组30例。组行腰麻，硬膜外腔置管，腰麻药0.5%罗哌卡因重比重液3 ml不足者酌情硬膜外腔追加0.75%罗哌卡因；N组采用神经刺激仪下腰丛坐骨神经阻滞，局麻药为0.45%罗哌卡因，腰丛阻滞剂量25～30 ml，坐股神经阻滞剂量20～25ml。记录并比较两组麻醉血流动力学、起效维持时间、麻醉效果、辅助用药、不良反应。结果 两组患者血流动力学比较，组麻醉后10min（T10）、麻醉后min（T）MAP下降（P＜0.05），T HR下降（P＜0.05），组T MAP、HR低于N组（P＜0.05）；组麻醉准备及操作时间（Tr）、感觉完全阻滞时间（T1）、运动完全阻滞时间（T2）、感觉恢复时间（T3）、运动恢复时间（T4）于N组（P＜0.05），术后首次排尿时间（Tu）长于N组（P＜0.05）；N组并发症少于组。结论用于时间 [关键词] 腰丛坐骨神经联合阻滞；腰麻；外周神经刺激器 Clinical tudy of lumbar plexus/sciatic nerve block using peripheral nerve stimulator and combined spinal-epidural anesthesia in arthroscopic knee surgery Zhang Wei, Fang Cai, Xie Yan-hu Department of Anesthesiology, Affiliated Anhui Provincial Hospital of Anhui Medical University，Hefei, Anhui, 230001 作者单位：230001合肥安徽医科大学附属省立医院麻醉科 ：方才doctor_fc@ [Abstract] Objective The study sought to compare the efficacy of lumbar plexus/sciatic nerve block using peripheral nerve stimulator and combined spinal-epidural anesthesia in arthroscopic knee surgery. Methods Sixty patients undergoing arthroscopic knee surgery were randomly divided into two groups, thirty in each: group C(combined spinal-epidural anesthesia group); group N(lumbar plexus/sciatic nerve block group). The patients in group C received spinal anestheisa and epidural catheter. The local anesthetic drug was 0.5% hyperbaric ropivacaine solution 3ml. Furthermore, 0.75% ropivicaine would be given through epidural catheter if necessary. The patients in group N received lumbar plexus/sciatic nerve block using peripheral nerve stimulator. The local anesthetic drug was 0.45% ropivacaine, and the amount of drug for lumber plexus blockade was 25～30～P＜0.05P＜0.05T20 in group C were lower(P＜0.05Tr(Anesthesia preparation and handling time), T1(the onset time of sensory block), T2(the onset time of motor block), T3(analgesia) and T4(the duration of motor block) of group C were shorter than those of group N(P＜0.05P＜0.05umb