外周神经刺激器辅助联合神经阻滞在单侧下肢手术中的应用  

Clinical Study of Lumbar Plexus-Sciatic Nerve Block Using Peripheral Nerve Stimulator in the Single Lower Extremity Surgery in Elderly Patients

作　　者：曾秋谷 杨奕尤 黎达锋 谭月仙 林保留 

机构地区：[1]阳江市人民医院,广东阳江529500

出　　处：《中外医学研究》2013年第5期5-7,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:观察外周神经刺激器辅助定位下腰丛联合坐骨神经阻滞在老年患者单侧下肢手术中的麻醉效果。方法:21例行单侧下肢手术老年患者在神经刺激仪辅助下行腰丛联合坐骨神经阻滞,局麻药为0.375%罗哌卡因,腰丛阻滞和坐骨神经阻滞各30ml。记录麻醉前后血流动力学、起效维持时问、麻醉效果及不良反应。结果:患者HR、MAP麻醉后各时点与麻醉前比较差异无统计学意义(P>0.05)。感觉神经阻滞起效时间(8.6±1.7)min,维持时间(418.2±113.7)min;运动神经效果评分改良Bromage法Ⅱ～Ⅲ级,运动阻滞起效时间(12.5±3.1)min,维持时间(178.7±38.8)min。麻醉效果优90.5%,良9.5%,均未出现局麻药毒性反应及神经并发症。结论:外周神经刺激器辅助定位下腰丛联合坐骨神经阻滞用于老年患者单侧下肢手术,血流动力学平稳,麻醉效果确切,并发症少,值得临床推广应用。Objective： To study sought to observe the efficacy of lumbar plexus-sciatic nerve block using peripheral nerve stimulator in the single lower extremity surgery in elderly patients. Methods： 21 patients undergoing the single lower extremity surgery were received lumbar plexus-sciatic nerve block using peripheral nerve stimulator. The local anesthetic drug was 0.375% ropivacaine, and the amount of drug for lumber plexus blockade and sciatic plexus blockade was 30 ml.The hemodynamics, onset time, duration, efficacy, and adverse reactions were recorded.Results： In hemodynamics, the mean artery pressure（MAP）and the hart rate（HR）of T^（ten minutes after anesthesia）, T2（thirty minutes after anesthesia） and T3（operation finish） had no significant difference than that of T0（baseline） （P〉0.05）; the onset time of sensory block was（8.6 ± 1.7）rain, and the duration was （418.2± 113.7）rain; the onset time of motor block was（12.5± 3.1）rain, and the duration was （178.7 ± 38.8）rain.The excellent anesthesia effect was 90.5% and the fine effect was 9.5%, all the people had few complications.Conclusion： The anesthetic strategy of lumbar plexus-sciatic nerve block using peripheral nerve stimulator will lead to precise anesthesia effect, complete blockade, stable hemodynamics and few complications, which were the reasons why it could be applicable to in the single lower extremity surgery in elderly patients.

关 键 词：外周神经刺激器 腰丛联合坐骨神经联合阻滞 老年患者 

分 类 号：R614[医药卫生—麻醉学]