神经刺激器定位腰丛-坐骨神经阻滞在高龄病人单侧下肢手术中的应用

Clinical Study of Combined Lumbar Plexus-sciatic Nerve Block Using the Peripheral Nerve Stimulator in Elderly Patients with Unilateral Lower Extremity Surgery

目的观察神经刺激器定位腰丛-坐骨神经阻滞应用于高龄病人单侧下肢骨科手术的效果。方法68例年龄≥75岁、拟行单侧下肢骨科手术的老年患者,根据麻醉方法随机分为组Ⅰ、组Ⅱ,各34例。组Ⅰ行常规腰硬联合麻醉,组Ⅱ以神经刺激器定位,实施腰丛-坐骨神经阻滞。观察两种方法的麻醉效应,以及对病人循环、呼吸功能的影响。结果两组患者麻醉效果满意,组Ⅰ病人麻醉后10 min,切皮时出现血压下降,呼吸频率增加,组Ⅱ循环、呼吸平稳;术后尿潴留发生率组Ⅱ明显低于组Ⅰ。结论外周神经刺激器定位腰丛-坐骨神经阻滞用于高龄病人下肢手术阻滞成功率较高,对循环功能影响较少,术后并发症少。

Objective To observe the effects of combined lumbar plexus - sciatic nerve block using the peripheral nerve stimulator in elderly patients with unilateral lower extremity surgery. Methods 68 elderly patients with age ≥75 years old undergoing unilateral lower limb orthopedic surgery were randomly divided into two groups ,group Ⅰ （the control group = 34） underwent routine combined epidural - spinal anesthesia, group Ⅱ （n = 34） underwent combine lumber plexus -sciatic nerve block guided by a nerve stimulator. The effects of anesthesia, circulation and respiratory function were observed. Results Both groups obtained good anesthesia effect, the blood pressure decreased in group Ⅰ after anesthesia while circulation and respiration in the group Ⅱ was stable, the incidence of urinary retention after surgery in group Ⅱ was significantly lower than group Ⅰ. Conclusion Combined lumbar plexus - sciatic nerve block using the peripheral nerve stimulator in elderly patients with unilateral lower extremity surgery has a higher success rate, have less impact on respiratory and circulatory functions for these patients, less post - operative complications.