腰丛-坐骨神经联合阻滞在高龄患者PFNA手术中的应用

Application of Combined Lumbar Plexus-Sciatic Nerve Block in PFNA Operation in Elderly Patients

目的:探讨神经刺激仪辅助下腰丛-坐骨神经联合阻滞在高龄患者单侧PFNA手术中的麻醉效果。方法:40例高龄患者分为腰硬联合阻滞组(C组)和神经阻滞组(N组),各20例,行单侧PFNA手术,记录以下时间点的SDP、DBP、HR数值及并发症发生情况:阻滞前、阻滞后5min、10min及15min、切皮后5min、手术结束时。结果:N组18例患者麻醉效果满意,2例患者出现阻滞不全,给予少量舒芬太尼顺利完成手术。与阻滞前比较,神经阻滞后患者的HR、SBP、DBP无明显变化(P>0.05),而与C组比较阻滞后5、10、15min,切皮后5min均有显著性差异。所有患者均未出现麻醉并发症。结论:腰丛-坐骨神经联合阻滞用于高龄老人单侧PFNA术,与腰硬联合阻滞能达到同样的麻醉效果,更安全。

Objective：To investigate the nerve stimulator assisted lumbar plexus combined sciatic nerve block in the elderly patients undergoing unilateral PFNA surgery anesthesia.Methods：40 cases of elderly patients were divided into combined spinal epidural anesthesia group（C group） and nerve block group（group N）,20 cases,underwent unilateral PFNA surgery,record the following time points SDP,DBP,HR value and complications：before anesthesia and 5min after anesthesia,10 min and 15 min,skin incision after the end of surgery,5min.Results：N group of 18 patients with satisfactory anesthesia,2 cases of patients with incomplete block,giving a small amount of sufentanil successfully completed surgery.Compared with the block before,after nerve block SBP,HR,DBP no significant change（P〉0.05）,and compared with the C group after block 5,10,15 min,5min after skin incision were significantly different All patients did not appear anesthesia complications.Conclusion：Combined lumbar plexus sciatic nerve block can be used in the elderly patients with unilateral PFNA,and combined with spinal epidural block can achieve the same effect of anesthesia.