超声引导下股神经阻滞和坐骨神经阻滞在急诊中的应用

Ultrasound guidence in nerve block of femoral nerve and sciatic nerve in emergency department

目的研究超声引导下股神经阻滞和坐骨神经阻滞在急诊膝关节以下手术中的应用。方法将40例小腿、足部或膝关节外伤拟行清创缝合手术的患者随机分为超声组20例和对照组20例。行患侧股神经和腘窝坐胃神经阻滞,对照组采用传统方法定位穿刺,超声组采用超声引导下定位。在穿刺点注入1.5%利多卡因,30 min内每5 min观察一次阻滞的效果。记录局麻药物起效时间,观察阻滞效果、镇痛维持时间及并发症发生情况。结果超声组局部麻醉药的起效时间比对照组短,超声组镇痛效果优于对照组。结论超声引导下股神经阻滞和坐骨神经阻滞比传统阻滞方法效果好。

Objective To investigate the application of ultrasound guidence in nerve block of femoral nerve and sciatic nerve in emergency department. Methods 40 patients who planned to accept surgery of feet, lower limb under knee were randomly derided into two groups： ultrasound guidended group and the control group. Femoral nerve and sciatic nerve were blocked by ultrasound guidended technique or classic landmark technique, 1.5% lidocaine was administered for nerve block. Sensory block was observed every 5 minutes in 30 minutes. Onset time, effect of anesthesia, algesia time and complications were recorded. T - test and varience difference were applied. Results The onset time of local anesthetics was faster in the ultrasound guided group than that of the control group. Effect of analgesia was better in in the ultrasound guided group than that of the control group. Conclusion Nerve block of femoral nerve and the sciatic nerve guided by uhrasound is better than the classic technique.