超声结合神经刺激仪引导下股神经联合坐骨神经阻滞在下肢手术中的临床评价

目的 观察超声结合神经刺激仪引导下实施股神经联合坐骨神经阻滞在下肢手术中的临床效果.方法 择期行下肢手术患者80例,将患者随机分为两组：脊髓麻醉组（S组）和股神经联合坐骨神经阻滞组（N组）.记录两组麻醉操作时间（OT）、手术等待时间（SWT）、手术时间（ST）、首次镇痛时间（FAT）、术中血压下降幅度、首次自主排尿时间（FUT）、患者对本次麻醉满意度.结果 与S组比较,N组OT、SWT、FAT时间较长（P〈0.01）;FUT时间较短（P〈0.01）;血压下降超过术前基线10%的患者数较少（P〈0.05）;两组患者满意度无显著差异（P〉0.05）.结论 超声结合神经刺激仪引导股神经联合坐骨神经阻滞在下肢手术中,可提供满意的神经阻滞效果;血流动力学稳定,镇痛时间长,无尿储留.

Objective To observe the clinical effects of combined femoral nerve and sciatic nerve block guided by ultrasound combined with nerve stimulator in lower limb surgery. Methods 80 patients with elective lower limb surgery were randomly divided into two groups：spinal anesthesia group（S）,associated femoral nerve and sciatic nerve block group（N）. The anesthesia operation time（OT）,surgery wait time（SWT）, surgery time（ST）,time to first analgesia（FAT）,range of intraoperative blood pressure decrease,time to first spontaneous urination（FUT）, patient satisfaction were recorded. Results Compared with group N,OT,SWT,FAT of group S were longer（P〈0.01）;FUT is shorter （P〈0.01）;the number of patients whose preoperative baseline blood pressure dropped by more than 10%（P〈0.05）was few;2 patients satisfaction was not significantly different（P〉0.05）. Conclusion Ultrasound combined with nerve stimulator guided femoral nerve and sciatic nerve block associated lower extremity surgery,nerve block can provide satisfactory results. But the flow mechanics is stable,the analgesia time is long,does not have the urine retention.