神经刺激仪定位下腰丛-坐骨神经阻滞对胫内平台骨折老年患者血流动力学的影响

Effects of Lumbar Plexus and Sciatic nerve Block Located by Nerve Stimulator on Hemodynamics in Patients with Senile Tibial Plateau Fracture

目的研究神经刺激仪定位下腰丛-坐骨神经阻滞对胫内平台骨折(TPF)老年患者血流动力学影响。方法选取2015年4月~2017年4月本院收治的40例TPF老年患者,随机数字表法分组,各20例。对照组采取腰硬联合麻醉,观察组采取神经刺激仪定位下腰丛-坐骨神经阻滞。统计对比两组麻醉起效时间,监测对比两组麻醉前、麻醉后5 min血流动力学[心率(HR)、舒张压(DBP)收缩压(SDP)]变化。结果观察组麻醉起效时间低于对照组,差异有统计学意义(P<0.05);麻醉前,两组HR、DBP、SDP指标对比差异均无统计学意义;麻醉后5 min,观察组HR、DBP、SDP指标高于对照组,差异有统计学意义(P<0.05)。结论老年TPF患者采取神经刺激仪定位下腰丛-坐骨神经阻滞,麻醉起效快,血流动力学影响小,安全性高。

Objective To study the effect of lumbar plexus and sciatic nerve block located by nerve stimulator on hemodynamics in patients with senile tibial plateau fracture(TPF).Methods 40 elderly patients with TPF in our hospital from April 2015 to April 2017 were randomly divided into groups,with each 20 cases.The control group was treated with combined spinal and epidural anesthesia.The observation group was treated with lumbar plexus and sciatic nerve block located by nerve stimulator.The onset time of anesthesia was compared between two groups.The changes of hemodynamics[heart rate(HR),diastolic blood pressure(DBP)and systolic blood pressure(SDP)]before and after the anesthesia for 5 min of the two groups were monitored and compared.Results The onset time of anesthesia in the observation group was shorter than that in the control group(P<0.05).Before anesthesia,there was insignificant difference between the two groups in HR,DBP and SDP.At 5 min after anesthesia,the indexes of HR,DBP and SDP in the observation group were higher than those in the control group(P<0.05).Conclusion The ultrasound combined with lumbar plexus and sciatic nerve block located by nerve stimulator on treating senile TPF patients can shorten the time of block completion.The anesthesia came into effect quickly with little hemodynamic influence and high safety.