神经刺激仪联合超声定位下0.3%的罗哌卡因行下肢神经阻滞的临床研究

Clinical Study of Nerve Stimulator Combined with Ultrasound-Guided 0.3% Ropivacaine for Lower Extremity Nerve Block

目的探讨神经刺激仪联合超声定位下0.3%的罗哌卡因行下肢神经阻滞的临床效果。方法临床纳入行下肢手术的患者80例,根据下肢神经阻滞方案的不同分为研究组和对照组各40例。研究组实施神经刺激仪联合超声定位,对照组实施神经刺激定位。两组患者均行单侧股神经-坐骨神经阻滞。分别记录两组患者阻滞前(T0)、阻滞后10min(T1)、阻滞后30min(T2)、阻滞后60min(T3)时收缩压(SBP)、舒张压(DBP)、心率(HR)等。另外,比较两组患者神经阻滞完成时间、阻滞起效时间及镇痛维持时间等。观察两组患者术后神经损伤并发症发生情况。结果两组患者T0、T1、T2、T3时SBP、DBP、HR等比较无显著性差异(P>0.05);研究组神经阻滞完成时间、阻滞起效时间、镇痛维持时间分别为9.9±2.1、8.5±0.6、763.1±61.2min,对照组分别为19.5±1.1、10.3±1.5、715.8±46.1min,两组比较差异显著(P<0.05)。结论神经刺激仪联合超声定位下0.3%的罗哌卡因行下肢神经阻滞,具有定位快速、准确、起效时间快、镇痛维持时间长等优点,且对患者的血液动力学无明显的影响,值得推广。

Objective To investigate the clinical effect of nerve stimulator combined with ultrasound-guided 0.3% ropivacaine for lower extremity nerve block.Methods 80 patients with lower limb surgery were included in the study group and control group,40 cases were divided into study group and control group. In the study group, the nerve stimulator was combined with ultrasonic positioning, and the control group was located in the nerve stimulation. Two groups of patients were performed unilateral femoral nerve sciatic nerve block. systolic blood pressure（SBP）, diastolic blood pressure（DBP） and heart rate（HR） were recorded before and after block（T0）, block 10min（T1）, block 30min（T2）, and block 60min（T3）. In addition, compared with the two groups of patients with nerve block completion time, block onset time and the duration of analgesia. The incidence of postoperative nerve injury was observed in the two groups.Results Two groups of patients T0, T1, T2, T3 SBP, DBP, HR,no significant difference（P〉0.05）; research group of nerve block completion time, block onset time, analgesia duration were 9.9 ±2.1min, 8.5 ±0.6min and76.31±61.2min. Control group were 19.5±1.1min,10.3±1.5min,715.8±46.1min, two group comparison difference significant（P〈0.05）.Conclusion Nerve stimulation apparatus combined with ultrasoundguided 0.3% ropivacaine and lower extremity nerve block, has the advantages of quick and accurate positioning, faster onset time, analgesia maintaining the advantages of long time and the hemodynamics of patients with no obvious effect, worthy of promotion.