前路坐骨神经和股神经阻滞联合喉罩在老年膝关节置换术中的应用

Application of anterior sciatic nerve and femoral nerve block combined with laryngeal mask airway in elderly patients with knee joint replacement

目的探讨前路坐骨神经和股神经阻滞联合喉罩在老年膝关节置换术中的应用效果,为围术期寻找有效安全的方法。方法将120例老年单侧膝关节置换患者随机分为静吸复合喉罩全麻组(A组)30例、股神经阻滞联合喉罩全麻组(B组)、股神经和腘窝上坐骨神经阻滞联合喉罩全麻组(C组)与股神经和前路坐骨神经阻滞联合喉罩全麻组(D组)30例,观察不同麻醉方式在成单侧膝关节置换术中的麻醉效果、术后镇痛、神经阻滞操作时间等方面的差异。结果 C组和D组术中血流动力学更稳定,明显优于A和B组(P<0.01),C组合D组之间差异无统计学意义,但是D组神经阻滞操作时间明显短于C组(P<0.05);C组和D组术后镇痛明显优于A和B组(P<0.01)。结论前路坐骨神经和股神经阻滞联合喉罩全麻应用于老年单侧膝关节置换术,术中麻醉效果明显,术后镇痛好,易于实施,是一种值得推广的麻醉方式。

Objective To investigate the effect of anterior sciatic nerve and femoral nerve block combined with laryngeal mask airway in the elderlypatients with knee joint replacement,and to find a safe and effective method for perioperative period.Methods120cases of elderly patientswith unilateral knee arthroplasty patients were randomly divided into for Intravenous Inhalation Combined with laryngeal mask anesthesia group(group A)30cases,femoral nerve block combined with laryngeal mask general anesthesia group(group B)and shares the nerve and popliteal sciaticnerve block combined with laryngeal mask general anesthesia group(Group C)and femoral nerve and anterior sciatic nerve block combined with laryngealmask anesthesia group(group D)30cases.The effects of different methods of anesthesia in unilateral total knee arthroplasty in the anestheticeffect and postoperative analgesia,nerve blocks operating time difference.Results Group C and group D had more stable hemodynamics,significantlybetter than group A and group B(P<0.01).There was no significant difference between group C and group D.But nerve block operation timeof group D was significantly shorter than group C(P<0.05).Group C and group D postoperative analgesia was better than that in group A and groupB(P<0.01).Conclusion anterior sciatic nerve and femoral nerve block combined with laryngeal mask airway general anesthesia used in elderly patientswith unilateral knee replacement surgery,anesthesia effect is obvious,postoperative analgesia is good,easy to implement,was a worthy of promotionof anesthesia.