超声引导下肢神经阻滞在踝部手术中的麻醉效果

Anesthetic effects of ultrasound guided lower extremity nerve block in ankle surgery

目的对超声引导下肢神经阻滞在踝部手术中的麻醉效果进行分析。方法选取2016年10月~2017年10月来我院诊治的94例踝关节手术患者作为研究对象,按照双盲法将其分为研究组(n=47)和参照组(n=47)。参照组患者行腰麻,研究组患者行超声引导下肢神经阻滞。比较两组患者的运动评分、感觉评分、麻醉效果及并发症发生情况。结果两组患者的各级运动和感觉评分比较,差异无统计学意义(P>0.05);研究组患者的术后感觉阻滞起效时间、运动阻滞起效时间、运动阻滞维持时间、术后镇痛持续时间长于参照组,下床活动时间短于参照组(P<0.05);研究组患者的并发症总发生率为6.38%,低于参照组的21.27%,差异有统计学意义(P<0.05)。结论超声引导下肢神经阻滞相比于腰麻来说对踝部手术患者的麻醉效果更好,有效缩短药物起效时间和患者下床活动时间,延长药物维持时间和镇痛持续时间,减少并发症的发生,临床应用价值较高。

Objective To analyze the anesthetic effects of ultrasound guided lower extremity nerve block in ankle surgery.Methods A total of 94 ankle patients undergoing ankle surgeries in our hospital from October 2016 to October 2017 were divided into research group(n=47)and reference group(n=47)according to a double-blind method.Patients in the reference group were provided with lumbar anesthesia,while in the research group,ultrasound guided lower extremity nerve block was adopted.The motor score,sensory score,anesthetic effect and occurrence of complications were comparatively analyzed.Results There was no significant difference in motor score or sensory score in different grading between the two groups(P>0.05).In the research group,the onset time of postoperative sensory block,the onset time of motor block,the maintenance of motor block,the duration of postoperative analgesia were longer than those in the reference group,while the the time for getting out of bed was shorter than that in the reference group,the differences were statistically significant(P<0.05).The total incidence of complications in the research group was 6.38%,which was lower than that in the reference group accounting for 21.27%,the difference was statistically significant(P<0.05).Conclusion Compared to lumbar anesthesia,ultrasound-guided lower extremity nerve block has a better anesthetic effect on patients with ankle surgery by effectively shortening the onset time of the drug and the time to get out of bed,prolonging the duration of drug maintenance and analgesia,and reducing the occurrence of complications,which has a higher value of clinical application.