腰丛-坐骨神经-股神经联合阻滞与硬膜外阻滞在老年患者下肢手术中的应用效果

Application effect of combined lumbar plexus-sciatic nerve-femoral nerve block and epidural block in lower limb surgery in elderly patients

目的比较腰丛-坐骨神经-股神经联合阻滞与硬膜外阻滞在老年患者下肢手术中的应用效果。方法将90例老年下肢手术患者根据单双号编号法随机分为试验组与对照组,各45例。试验组给予腰丛-坐骨神经-股神经联合阻滞,对照组给予硬膜外阻滞。比较两组不同时间点的血流动力学指标、麻醉相关指标、麻醉效果及不良反应发生情况。结果T1时,试验组的HR、DBP、SBP均优于对照组(P<0.05)。试验组的感觉阻滞起效时间、运动阻滞起效时间均短于对照组,感觉阻滞持续时间、运动阻滞持续时间均长于对照组(P<0.05)。试验组的麻醉优良率高于对照组,差异具有统计学意义(P<0.05)。两组的尿潴留、恶心呕吐、神经损伤、躁动发生率无显著差异(P>0.05)。结论腰丛-坐骨神经-股神经联合阻滞应用于老年下肢手术患者中,可获得较好的麻醉效果,且对患者血流动力学的影响小,安全有效。

Objective To compare the application effect of combined lumbar plexus-sciatic nerve-femoral nerve block and epidural block in lower limb surgery in elderly patients.Methods A total of 90 elderly patients with lower limb surgery were randomly divided into experimental group and control group according to single and double number method,with 45 cases in each group.The experimental group was given combined lumbar plexus-sciatic nerve-femoral nerve block,while the control group was given epidural block.The hemodynamic indexes at different time points,anesthesia related indexes,anesthesia effect and adverse reactions were compared between the two groups.Results At T1,HR,DBP and SBP of the experimental group were better than those of the control group(P<0.05).The onset time of sensory block and motor block in the experimental group were shorter than those in the control group,and the duration of sensory block and motor block in the experimental group were longer than those in the control group(P<0.05).The excellent and good rate of anesthesia in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the incidences of urinary retention,nausea and vomiting,nerve injury and restlessness between the two groups(P>0.05).Conclusion Combined lumbar plexus-sciatic nerve-femoral nerve block applied to elderly patients with lower limb surgery can obtain better anesthetic effect,and has little impact on hemodynamics,which is safe and effective.