腰丛联合坐骨神经阻滞在糖尿病足截肢术中的应用

Application of combined lumbar plexus-sciatic nerve block in patients undergoing diabetic foot amputation

目的探讨腰丛联合坐骨神经阻滞应用于糖尿病足截肢术的应用。方法 60例糖尿病足截肢术的患者,分为两组,各30例,分别给予腰丛联合坐骨神经阻滞(1组)和腰硬联合麻醉(2组)。监测并记录两组患者入室后不同时间的血压、心率、血氧饱和度、有无麻醉并发症、不良反应和麻醉效果。结果两组麻醉前、后心率,麻醉操作时间,脉搏氧饱和度差异无统计学意义(P>0.05);2组平均动脉压较1组下降明显且麻醉疗效满意时间短(P<0.05),1组镇痛时间长(P<0.05)。结论腰丛联合坐骨神经阻滞麻醉对患者血压的影响少,且术后镇痛时间长,对糖尿病足截肢术的患者麻醉效果良好。

Objective： To investigate the application of combined lumbar plexus-sciatic nerve block in patients undergo- ing diabetic foot amputation. Methods： Sixty patients undergoing diabetic foot amputation were assigned to two groups. 30 patients undergoing lumbar plexus-sciatic nerve block were Group 1,30 patients undergoing combined spinal-epidural anes- thesia were Group 2. To monitor and record the mean arterial pressure （ MAP）, heart rate, bood oxygen saturation of dif- ferent times, complications, adverse reaction and anesthetic effect. Resluts： There was no statistically significant difference in heart rate, operation time, blood oxygen saturation （ P 〉 0.05）. MAP of Group 2 was decreased significantly, satisfac- tory effect time of Group 2 was shorter （ P 〈 0.05 ）. The analgesia time of group 1 was longer（ P 〈 0.05 ）. Conclusion： Combined lumbar plexus-sciatic nerve block is better for patients undergoing diabetic foot amputation in the less effect of MAP and longer analgesia time.