神经刺激器定位下坐骨神经阻滞在足踝部手术麻醉中的应用  

Clinical application of sciatie nerve block by neural stimulator location for foot and ankle surgery

作　　者：孙友谦[1] 

机构地区：[1]首都医科大学附属北京中医医院麻醉科,100010

出　　处：《中国医药》2011年第3期316-317,共2页China Medicine

摘　　要：目的 比较神经刺激器定位下坐骨神经阻滞与蛛网膜下腔阻滞（腰麻）对足踝部手术的麻醉效果.方法 选择足踝部择期手术患者60例,完全随机分为坐骨神经阻滞组和腰麻组,各30例.观察和记录2组患者麻醉起效时间、麻醉效果、阻滞完善率等,并观察2组不良反应情况.结果 坐骨神经阻滞组和腰麻组感觉阻滞起效时间分别为（7.5±2.3）和（0.5±0.2）min,运动阻滞起效时间分别为（9.4±3.6）和（1.6±0.5）min,差异均有统计学意义（均P＜0.01）.坐骨神经阻滞组和腰麻组完全阻滞率差异无统计学意义.坐骨神经阻滞组恶心呕吐、呼吸抑制、低血压、尿潴留的发生率[3.3%（1例）、03.3%（1例）、0]明显少于腰麻组[16.7%（5例）、13.3%（4例）、20.0%（6例）、13.3%（4例）]（P＜0.05或P＜0.01）.结论 对于足踝部手术,神经刺激器定位下坐骨神经阻滞与腰麻一样可以满足麻醉镇痛需要,且不良反应少.Objective To observe the effects of sciatic nerve block by peripheral nerve stimulator-guided and spinal block for foot and ankle surgery. Methods Sixty patients scheduled for foot and ankle surgery were randomly divided into two groups with 30 patients each. The patients in group N received sciatic nerve block by nerve stimulator（frequency 2 Hz, intensity 0.4-0.6 mA）, and the patients in group E received spinal block. The onset time, anesthesia effects and adverse reactions in both groups were compared. Results The onset time of sensor and morter block in group N and E were （7. 5 ± 2.3 ） min, （9.4 ± 3.6 ） min and （0.5 ± 0.2 ）, （ 1.6 ± 0. 5 ） min, the difference were significantly （P 〈 0.01 ）. The patients in both groups were provided better pain relief, and the Bromage scores were 3. The completely block rate in two groups were 96.7% （29） and 93.3% （28） respectively（ P 〉0.05）, The incidence of nausea and vomiting, respiratory inhibition, hypotension and urinary retention in group N [3.3% （1）, 0.0% （0）, 3.3% （1）, 0.0% （0） respectively] was lower than that of in group E[16.7% （5）, 13.3% （4）, 20.0% （6）, 13.3 % （4） respectively] （ P 〈 0.05 or P 〈 0.01 ）. Conclusion Sciatic nerve block can also satisfy the needs of foot and ankle surgery anesthesia as spinal block, with less adverse reactions.

关 键 词：坐骨神经阻滞 神经刺激器 蛛网膜下腔阻滞 

分 类 号：R614.4[医药卫生—麻醉学]