局麻下行膝关节关节镜手术的应用体会

Clinical experience of knee arthroscopic surgery under local anesthesia

目的探讨在膝关节关节镜手术中局部麻醉的可行性和优越性。方法用2%利多卡因20.0 ml+1%盐酸肾上腺素0.5 ml+生理盐水30.0 ml做穿刺点局部浸润麻醉及关节腔内表面麻醉,观察186例局麻下行膝关节关节镜手术患者的麻醉满意度及手术效果。结果所有患者均按计划完成膝关节关节镜下手术,术后无麻醉并发症发生,患者术中麻醉满意度达94.62%。根据日本骨科协会评估治疗分数(JOA)膝骨性关节炎治疗效果判定标准,术后半年平均得分92.5分。术后半年按患者的主观评定分级,优良率达91.94%。结论局部麻醉可满足部分膝关节疾病关节镜手术的需要,局麻下行膝关节关节镜手术完全可行,有安全、简便、对全身状况影响小、麻醉并发症少和费用少等优点。

【Objective】To investigate the feasibility and superiority that the knee arthroscopic surgery under local anesthesia. 【Methods】To do the local infiltration anesthesia and the intra-articular surface anesthesia with 2%lidocaine 20.0ml ＋ 1% adrenaline hydrochloride 0.5 ml ＋ normal saline 30.0 ml, to observe the anesthesia satisfaction and operation result of 186 cases patient that had been operated with arthroscopic under local anesthesia.【Results】All the knee arthroscopic surgery were accomplished under local anesthesia, there has not complications in anesthesiology, the patient＇s anesthesia satisfaction is 94.60 % during the operation. The effect was evaluated by JOA knee osteoarthritis treatment decision criteria, the average score is 92.5 points after half a year. According to the patient＇s subjective evaluation of grading after half a year, the good rate is 91.94 %. 【Conclusion】The local anesthesia can meet the needs of the part of the knee joint disease arthroscopy surgery, completely feasible anesthesia downlink knee arthroscopy surgery, it has a lots of advantages, such as： safe, simple and little influence on the general situation, the complications in anesthesiology is little,the cost is less.