超声联合神经刺激仪在下肢神经阻滞教学中的应用

The Comparative Study of Ultrasound Combined With Nerve Stimulator in Lower Limb Nerve Block for Anesthesiology Teaching

目的探讨超声联合神经刺激仪定位在麻醉专业住院医师股神经和坐骨神经阻滞教学中的作用。方法将麻醉科进行规范化培训的45名住院医师作为研究对象,按照随机数字表法分为三组:神经刺激仪组(C组)、超声引导组(U组)、超声引导联合神经刺激仪组(US组),每组15名。三组医师分别采用神经刺激仪、超声或超声联合神经刺激仪进行股神经和坐骨神经阻滞的培训。培训后对三组医师进行评估,每位医师为3位患者进行股神经和坐骨神经阻滞操作,观察三组医师股神经和坐骨神经阻滞的操作时间、起效时间、麻醉阻滞效果、不良反应情况以及患者和住院医师的满意度。结果与C组和U组相比,US组的操作时间明显缩短(P<0.05);US组的麻醉起效时间短于C组和S组(P<0.05),神经阻滞麻醉效果优于C组和U组(P<0.05),US组患者和住院医师满意度明显提高(P<0.05),C组和U组患者不良反应发生率均高于US组,但差异无统计学意义(P>0.05)。结论超声联合神经刺激仪可以迅速提高麻醉专业住院医师股神经和坐骨神经阻滞麻醉的成功率,提高患者和住院医师的满意度。

Objective To explore the effectiveness of ultrasound combined with nerve stimulator to guide femoral and sciatic nerve block in clinical anesthesia teaching.Methods Forty-five junior residents of anesthesiology were randomly allocated into 3 groups by random numbers table method:nerve stimulator group(group C),ultrasound group(group U),ultrasound combined with nerve stimulator group(group US),with 15 each group.After training of femoral and sciatic nerve block,residents in three group were assessed.Each resident performed nerve block on three patients.We observed the three groups in anesthesia time in the femoral and sciatic nerve block,onset time,effect of anesthesia,adverse reactions as well as the patients and residents satisfaction.Results In group US manipulation time femoral and sciatic nerve block were shorter than group C and group U(P<0.05).Group US was superior to the group C and group U because of better anesthesia effect(P<0.05)and significantly reduced onset time(P<0.05)and increased satisfaction from the patients and residents(P<0.05).The incidence of adverse reactions in group C and group U were higher than that of group US,but the difference was not statistically significant(P>0.05).Conclusion Ultrasound combined with nerve stimulator can quickly improve the successful rate of sciatic nerve and femoral nerve block in clinical teaching for the junior residents of anesthesiology,and increase the satisfaction of patients and residents.