超声引导下神经阻滞技术在“和谐使命-2018”海外医疗服务任务中的应用

The application of ultrasound-guided nerve block in “Mission Harmony-2018” oversea medical service

目的通过分析与总结“和谐使命-2018”任务中接受超声引导下神经阻滞麻醉与镇痛的病例,探索海外医疗服务中神经阻滞在快速康复外科中的价值。方法回顾性分析任务中在麻醉条件下接受四肢手术的患者临床资料,筛选患者并完善术前相关检查,在获得患者和家属充分的理解与同意基础上,利用0.375%罗哌卡因复合0.5%利多卡因实施超声引导下神经阻滞麻醉技术,术后观察患者进水时间、下床时间、住院时间,并评估患者疼痛评分、满意度评分。结果共实施各类超声引导下神经阻滞4例,分别为闭孔神经+股神经阻滞、臂丛神经阻滞、腓总神经阻滞和坐骨神经阻滞,所有病例均顺利接受麻醉与手术,无相关不良事件发生。术后平均进水时间为(2.9±1.2)h,下床时间为(3.8±1.3)h,平均住院时间(2.5±1.0)d。术后24 h患者疼痛评分平均为(2.8±1.0)分,满意度高达(96.3±4.8)%。结论在“和谐使命-2018”海外医疗服务任务中实施超声引导下神经阻滞技术,麻醉与镇痛效果好,术后康复速度快,患者满意度高,值得今后的任务借鉴。

Objective To investigate the role of nerve block in the enhanced recovery after surgery during the oversea medi⁃cal service by analysis and conclude the patients undergoing ultrasound-guided nerve block anesthesia and analgesia during the“Mis⁃sion Harmony-2018”.Methods Patients undergoing limb surgeries with anesthesia were recruited.Preoperative examinations were completed.The understanding and consent were obtained from the patients and their relatives.Nerve block was performed with 0.375%ropivacaine and 0.5 lidocaine.The time of drinking water,standing up and hospitalization was recorded.The pain score and satisfacto⁃ry score were further assessed.Results A total of 4 cases of nerve block was performed,including the block of the obturator nerve and the femoral nerve,brachial plexus block,common peroneal nerve block and sciatic nerve block.All cases of anesthesia and sur⁃gery were expected to be completed successfully without any adverse event.The average time of drinking water was(2.9±1.2)h and the time of standing up was(3.8±1.3)h.The mean hospitalization duration was(2.5±1.0)days.Pain score at 24 h after surgery was 2.8±1.0 and the satisfactory score was(96.3±4.8)%.Conclusion Ultrasound-guided nerve block during the“Mission Harmony-2018”oversea medical service provides satisfactory anesthesia and an⁃algesia,with rapid recovery and high satisfaction,which can be widely applied in the similar missions afterwards.