超声引导骶管阻滞用于肥胖患者的价值：与传统定位法比较  

Value of ultratsound-guided sacral block in obese patients： a comparison with traditional positioning method

作　　者：解淑灿 黄长顺[1] 邵景汉[1] 卢子会[1] 何亮亮[2] 

机构地区：[1]宁波市第一医院麻醉科,315010 [2]首都医科大学宣武医院疼痛科,315010

出　　处：《中华麻醉学杂志》2014年第6期724-726,共3页Chinese Journal of Anesthesiology

摘　　要：目的通过与传统定位法比较，评价超声引导骶管阻滞用于肥胖患者的价值。方法择期拟行肛肠手术肥胖患者60例，年龄25～50岁，体重56～80妇，体重指数≥30kg／m＾2，ASA分级I或Ⅱ级，采用随机数字表法分为2组（n=30）：传统定位法组（T组）和超声引导骶管阻滞组（U组）。分别采用超声定位法和传统定位法定位骶管穿刺点，穿刺成功后注射1％利多卡因20ml。记录一次穿刺成功例数和穿刺时间≤1min例数，记录不良反应的发生情况，评价骶管阻滞效果。结果与T组比较，Ｕ组一次穿刺成功率升高（P〈0．05），穿刺时间≤1min例数和骶管阻滞效果差异无统计学意义（P〉0．05）。2组患者均未见不良反应发生。结论与传统定位法相比，超声引导骶管阻滞用于肥胖患者可提高一次穿刺成功率，且阻滞效果相似，有显著临床价值。Objective To evaluate the efficacy of ultrasound-guided sacral block in the obese patients by comparing it with the traditional positioning method. Methods Sixty obese patients, aged 25-50 yr, weighing 56- 80 kg, with body mass index≥30 kg/m^2 , scheduled for elective anorectal surgery, were randomly divided into 2 groups （n = 30 each） using a random number table： ultrasound-guided sacral block group （group U） and traditional positioning method group （group T）. The sacral canal puncture point was located via either ultrasonic or traditional positioning method. After successful puncture, 1% lidocaine 20 ml was injected. The number of patients in whom puncture was successful at first attempt and the number of patients in whom the time for puncture ≤ 1 min were recorded. The adverse reactions were observed. The efficacy of sacra/block was evaluated. Results Compared with group T, the success rate of puncture at first attempt was significantly increased （ P 〈 0.05）, and no significant changes were found in the number of patients in whom the time for puncture ≤1 min or efficacy of sacral block in group U （ P 〉 0.05）. No adverse reactions were found in the two groups. Conclusion Ultrasound-guided sacral block can raise the success rate of puncture at first attempt and provide similar efficacy of block in the obese patients when compared with the traditional positioning method, and thus has significant clinical value.

关 键 词：超声检查 麻醉 脊尾 肥胖症 

分 类 号：R445.1[医药卫生—影像医学与核医学]