改良髂筋膜间隙联合腘窝坐骨神经阻滞在单侧大隐静脉曲张手术中的麻醉效果

Anesthetic effect of modified iliofascial space combined with axillary sciatic nerve block in unilateral saphenous vein surgery

目的 分析改良髂筋膜间隙联合腘窝坐骨神经阻滞在单侧大隐静脉曲张手术中的应用效果.方法 选择2014年3月至2017年11月于阳泉煤业集团第三医院行单侧大隐静脉曲张手术的患者100例,随机分为两组,每组50例.对照组行硬膜外阻滞,观察组行改良髂筋膜间隙联合腘窝坐骨神经阻滞,比较两组麻醉效果、感觉阻滞起效时间、阻滞完成时间、手术时间及不良反应发生情况.结果 两组手术时间、感觉阻滞完成时间比较差异未见统计学意义(P>0.05);与对照组比较,观察组感觉阻滞起效时间更短(P<0.05);观察组临床麻醉优良率为98.00%,对照组为100.00%,两组比较差异未见统计学意义(χ^2=1.0101,P>0.05);两组头痛、恶心呕吐发生率比较,差异未见统计学意义(P>0.05);观察组尿潴留发生率为0,低于对照组的24%(P<0.05).结论 单侧大隐静脉曲张手术中应用改良髂筋膜间隙联合腘窝坐骨神经阻滞,其麻醉效果显著,安全性高,值得推广.

Objective To analyze the application effect of modified iliofascial space combined with axillary sciatic nerve block in unilateral saphenous vein surgery.Methods A total of 100 patients who underwent unilateral saphenous varices surgery in the Third Hospital of Yangquan Coal Industry Group from March 2014 to November 2017 were randomly divided into two groups,with 50 cases in each group.Patients in control group received epidural block and patients in observation group underwent modified iliofascial space combined with axillary sciatic nerve block.The anesthetic effect,onset time of sensory block,completion time of block,operation time,and incidence of adverse reactions were compared between the two groups.Results There was no significant difference between the two groups in operation time and completion time of the block (P>0.05).Compared with control group,the onset time of sensory block was shorter in observation group,and the difference was significant (P <0.05). The excellent clinical anesthesia rate of observation group was 98.00%,and it was 100.00% in control group,but there was no significant difference between the two groups (χ^2=1.0101,P>0.05).There was no significant difference in the incidence of headache,nausea or vomiting between the two groups (P>0.05).The incidence of urinary retention in observation group was 0,which was significantly lower than 24%in control group (P<0.05).Conclusions The modified iliofascial space combined with axillary sciatic nerve block in unilateral saphenous vein surgery has significant effect and high safety.It is worthy of popularizing.