膝关节镜手术连续股神经镇痛治疗探究.docVIP

膝关节镜手术连续股神经镇痛治疗探究[摘要] 目的:观察膝关节镜手术中连续股神经镇痛的效果。方法:收集我院2006年10月～2009年10月120例膝关节镜手术患者的临床资料,所有患者均使用坐骨神经联合腰丛神经阻滞麻醉,术中用止血带。麻醉完成后30 min内进行手术,手术时间30～90 min。记录患者术中切口疼痛、止血带反应及麻醉持续时间。术后关节腔内注射0.1%吗啡注射液20 ml保留12 h。结果:98.3%的患者手术效果满意,3例(2.5%)患者因止血带反应需加用静脉麻醉或笑气(N2O)吸入麻醉。所有患者不需术后持续镇痛,麻醉失效后5～14 h内感到切口疼痛,平均8.1 h。所有患者对麻醉效果满意。结论:神经阻滞麻醉对下肢关节镜手术有良好的麻醉效果,术中及术后处理简单,是一种优良的关节镜手术麻醉方式。 [关键词] 膝关节镜手术;连续股神经;镇痛 [中图分类号] R681.8 [文献标识码]B[文章编号]1673-7210(2010)05(c)-153-02 Knee arthroscopy for continuous femoral nerve pain therapy HU Guohong (Department of Anesthesiology, Peking University Shenzhen Hospital, Shenzhen 518036, China) [Abstract] Objective: To observe the analgesic effect of continuous femoral nerve in knee arthroscopic surgery. Methods: 120 cases of patients underwent knee arthroscopy were selected in our hospital from October 2006 to October 2009; all patients were used the combined spinal-sciatic nerve plexus block anesthesia, surgery using a tourniquet. Operation within 30 min after anesthesia surgery, operative time was 30-90 min. Recorded for patients undergoing incision pain, tourniquet response and anesthesia duration. Knee arthroscopic surgery by 0.1% after intra-articular were injected of Morphine Injection 20 ml and reservation for 12 h. Results: 98.3% of the patients’ anesthesia was satisfactory, 3 cases(2.5%) needed for tourniquet was added intravenous anesthesia or nitrous oxide (N2O) inhalation anesthesia. All patients did not need postoperative continuous analgesia, in the 5-14 h after anesthesia began to feel the incision pain, with an average of 8.1 h. All patients were satisfied with anesthetic effect. Conclusion: Nerve block anesthesia of the lower limb arthroscopic surgery has good anesthesia, intraoperative and postoperative handling simple, it is a good arthroscopic surgery anesthesia. [Key words] Knee arthroscopic surgery; Continuous femoral nerve; Analgesia 关节镜手术是关节外科的一种微创性手术方法,是关节手术中的一个划时代的革新。早在20世纪30年代就有医生尝试用内镜进行膝关节检查,随着现代光学、电子学和图像技术的发展,70年代以