股神经三合一复合坐骨神经阻滞用于膝部手术的临床研究

Comparison study of clinical effectiveness of sciatic femoral three-in-one block and sciatic lumbar plexus block for knee operation

目的比较股神经三合一复合坐骨神经阻滞和腰丛复合坐骨神经阻滞在膝部手术的临床效果。方法择期行膝部手术患者60例,随机分为两组,分别采用股神经三合一复合坐骨神经阻滞(A组)和腰丛复合坐骨神经阻滞(B组)。记录感觉和运动阻滞起效时间,感觉、运动阻滞时间、阻滞成功率及止血带引发疼痛的情况,同时记录操作时间、操作满意度、手术的满意度及舒芬太尼使用率。结果两组感觉和运动阻滞起效时间、感觉、运动阻滞时间、阻滞成功率差异无统计学意义。A组操作时间明显短于B组,操作满意度明显高于B组(P<0.05);A组止血带引发疼痛明显高于B组,手术满意度明显低于B组,舒芬太尼使用率明显高于B组(P<0.05)。结论股神经三合一复合坐骨神经阻滞和腰丛复合坐骨神经阻滞都能满足膝部手术的镇痛需要。前者在手术满意度、耐受止血带及舒芬太尼使用上劣于后者,操作时间和操作满意度方面优于后者。

Objective To compare the clinical effectiveness of sciatic femoral three-in-one block and sciatic lumbar plexus block for knee operation.lVlethods Sixty patients undergoing knee operation were randomly divided into group A （sciatic femoral 3-in-1 block） and group 13 （sciatic lumbar plexus block） with 30 cases each. Sensory and motor block onset time, sensory and motor block durations, rate of block success and pain caused by the applied tourniquet was recorded. Time of anesthesia procedure, satisfaction of anesthesia procedure, satisfaction of operation and frequency of required sufentanil was also recorded.Results There was no difference between the group A and group B in sensory and motor block onset time, sensory and motor block durations and rate of block success. Time of anesthesia procedure was significantly shorter in the group A than in the group B, satisfaction of anesthesia procedure was significantly higher in the group A than in the group B （P〈 0. 05）. Pain caused by the applied tourniquet and frequency of required sufentanil in the group A were significantly higher than that in group B （P 〈 0.05）. Satisfaction of operation in group A was significantly lower than it in group B （P〈0. 05）.Conclusion Both group A and group B provided sufficient analgesia for knee operation. Group B may be preferable to group A, owing to better satisfaction of operation, less pain caused by the applied tourniquet and frequency of required Sufentanil. However, group A may be preferable to group B for shorter time of anesthesia procedure and better satisfaction of anesthesia procedure.