超声引导下股神经阻滞刺激与非刺激导管的比较  

THE EFFECT OF STIMULATING VERSUS UNSTIMULATING CATHETERS FOLLOWING UNLTRASOUND-GUIDED FEMORAL NERVE LOCALIZATION

作　　者：邓莹[1] 姜天乐[2] 郭向阳[1] 

机构地区：[1]北京大学第三医院麻醉科,北京100191 [2]首都医科大学附属北京世纪坛医院麻醉科,北京100038

出　　处：《中国疼痛医学杂志》2014年第2期104-107,共4页Chinese Journal of Pain Medicine

摘　　要：目的:在超声联合神经刺激器引导下行股神经置管,比较刺激型导管与非刺激型导管在穿刺过程中的穿刺时间、次数及术后患者静态视觉模拟评分(VAS)。方法:选取择期行全膝关节置换术患者40例,随机分为非刺激导管组(N组,n=20)和刺激导管组(S组,n=20)。均于术前在超声联合神经刺激器引导下行股神经置管。比较置管时间、此时及术后各时间点患者VAS评分。结果:N组的操作时间明显短于S组(P<0.05),穿刺次数少于S组(P<0.05)。术后两组患者各时间点静态VAS评分差异无统计学意义。两组48小时镇痛泵用量、哌替啶用量,不良反应发生率均无统计学差异(P>0.05)。两组患者术后均未出现神经并发症及拔管困难。结论:超声定位下股神经连续阻滞可以消除刺激导管与非刺激导管在操作和术后镇痛效果的差异。在超声引导下,非刺激导管的穿刺时间和次数更少,对患者造成的创伤更小。Objective： To compare the analgesic effect of catheterization of femoral nerve sheath guided by ultrasound and assisted with peripheral nerve stimulator in patents undergoing total knee replacement. Method： Fourty ASA I - II patients, aged 60 - 80 years, undergoing elective total knee arthroplasty, were randomized to receive catheterization with either nonstimulationg catheter （Group N） or stimulating catheter （Group S）. All patients received preoperative continuous femoral nerve blocks guided with ultrasound and nerve stimulator. The primary outcomes were sensory block success rate and number of attempts. Other outcomes were the quality of analgesia in different times after operation. Results： The time and rates required to position the catheter were greater in Group S than Group N （P 〈 0.05）. Quality of analgesia was similar at all time intervals （P 〉 0.05）. Conclusions： Ultrasound guidance for femoral nerve block results in similar block characteristics between stimulating and nonstimulating catheters. Nonsitmulating catheters had the superiority when punctured with ultrasound.

关 键 词：股神经 超声 镇痛 

分 类 号：R614[医药卫生—麻醉学]