改良超声引导"三叶草法"腰丛神经阻滞应用于单侧下肢手术患者的麻醉效果分析

Analysis of Anesthetic Effect of Modified Ultrasound-Guided"Cloverleaf Method"Lumbar Plexus Block in Patients Undergoing Unilateral Lower Limb Surgery

目的:观察单侧下肢手术患者应用改良超声引导"三叶草法"腰丛神经阻滞后的麻醉效果。方法:根据随机数字表法,将我院2020年12月~2023年3月期间收治的86例单侧下肢手术患者分为A组(n=43)和B组(n=43)。A组手术期间接受超声引导"三叉戟"LPB技术定位,B组手术期间接受改良超声引导"三叶草法"定位。对比两组一次神经阻滞成功率、调整穿刺针方向次数、定位时间、穿刺时间、麻醉效果优良率、疼痛视觉模拟评分(VAS),同时观察两组治疗期间不良反应发生情况。结果:B组的一次神经阻滞成功率高于A组,调整穿刺针方向次数少于A组,定位时间、穿刺时间短于A组(P<0.05)。B组麻醉效果优良率高于A组(P<0.05)。B组术后6 h、12 h、24 h VAS评分低于A组(P<0.05)。两组不良反应发生率对比未见差异(P>0.05)。结论:与超声引导"三叉戟"LPB技术应用于单侧下肢手术患者相比,改良超声引导"三叶草法"定位可缩短定位时间、穿刺时间,减少调整穿刺针方向次数,减轻术后疼痛,提高麻醉效果。

Objective:To observe the anesthetic effect of modified ultrasound-guided"cloverleaf method"lumbar plexus block in patients undergoing unilateral lower limb surgery.Methods:According to the random number table method,86 patients with unilateral lower limb surgery who were admitted to our hospital from December 2020 to March 2023 were divided into group A(n=43)and group B(n=43).Group A received ultrasound-guided"Trident"LPB technology,and group B received modified ultrasound-guided"cloverleaf method"positioning.The success rate of one-time nerve block,the number of times to adjust the direction of the puncture needle,the positioning time,puncture time,excellent rate of anesthesia,visual analogue scale(VAS)of pain were compared between two groups,and the adverse reactions during the treatment were observed.Results:The success rate of one-time nerve block in group B was higher than that in group A,the number of times to adjust the direction of the puncture needle was less than that in group A,and the positioning time and puncture time were shorter than those in group A(P<0.05).The excellent rate of anesthesia in group B was higher than that in group A(P<0.05).The VAS scores in group B at 6 h,12 h and 24 h after operation were lower than those in group A(P<0.05).There was no difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Compare with the application of ultrasound-guided"Trident"LPB technology in patients undergoing unilateral lower limb surgery,the improved ultrasound-guided"cloverleaf method"positioning can shorten the positioning time and puncture time,reduce the the number of times to adjust the direction of the puncture needle,reduce postoperative pain,and improve the anesthetic effect.