神经刺激仪定位下腰丛联合坐骨神经阻滞在老年膝关节镜手术中的应用  

With the help of a nerve stim ulat lumbar-sciatic nerve block applied in knee arithroscopic surgery

作　　者：宋杰[1] 孙明丽[1] 陈美璞[1] 丁保峰[1] 潘振国[1] 

机构地区：[1]山东聊城第二人民医院(泰山医学院附属聊城二院)麻醉科,山东聊城252601

出　　处：《中国现代医学杂志》2009年第23期3650-3652,3655,共4页China Journal of Modern Medicine

摘　　要：目的探讨丁丙诺菲复合罗哌卡因用于腰丛联合坐骨神经阻滞的安全性和有效性。方法选择ASA1、2级拟行单侧下肢关节镜手术患者60例,随机分为两组,每组30例,分别以0.5%罗哌卡因+0.15mg丁丙诺菲和0.5%罗哌卡因在神经刺激仪定位下行腰丛和坐骨神经阻滞,观察患者阻滞后感觉和运动阻滞效果,阻滞时程,术中患者自觉症状。结果两组患者起效时间无明显差异,但0.5%罗哌卡因+0.15mg丁丙诺菲组比0.5%罗哌卡因组运动和感觉阻滞时程明显延长,具有统计学差异。结论0.5%罗哌卡因+0.15mg丁丙诺菲组用于腰丛坐骨神经联合阻滞时比0.5%罗哌卡因作用更完善,持续时间更长,对于下肢手术和术后镇痛更为适宜。【Objective】To investigate the efficacy and safety of Ropivacaine combined with Buprenorph for lumbar-sciatic nerve block.【Methods】Sixty patients ASA1～3 scheduled for knee arithroscopic surgery were ramdomly divided into two groups, each group with 20 patients. Lumbar plexus combined sciatic nerve block was performed with the help of a nerve stimulator and 0.5% Ropivacnine ＋0.15 mg Buprenorph or 0.5% Ropivacain was administered in each group respectively. The blockade effect of motor and sensory nerve in each group respectively. The blockade minutes of motor and sensory nerve, the duration of analgesia were evaluated. [ Results ] There was no significant difference on the blockade effect between the two group, but a longer duration of motor and sensory blockade was found in 0.5% Ropivacaine ＋0.15 mg Buprenorph group than in 0.5% Ropivacain group. [Conelusion] 0.5% Ropivacaine ＋0.15 mg Buprenorph will produce a better anagestic effect in lure bar plexus combined sciatic nerve block than 0.5% Ropivacaine, and is more suitable for deeper lower limb operation and postoperative analgesia.

关 键 词：腰丛神经阻滞 坐骨神经阻滞 神经刺激仪 丁丙诺菲 关节镜 

分 类 号：R745.4[医药卫生—神经病学与精神病学]