腰丛神经阻滞用于老年患者单侧股动脉-股深动脉人工血管旁路术的可行性  

Feasibility of using lumbar plexus block for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients

作　　者：王武[1] 吴绍芳[2] 郑旺福[1] 吴炜[1] 周娅梅[1] 雷李培[1] 

机构地区：[1]浙江省丽水市中心医院麻醉科,323000 [2]浙江省丽水市中心医院皮肤科,323000

出　　处：《中华麻醉学杂志》2014年第10期1234-1236,共3页Chinese Journal of Anesthesiology

摘　　要：目的 评价腰丛神经阻滞用于老年患者单侧股动脉-股深动脉人工血管旁路术的可行性.方法 择期行单侧股动脉-股深动脉人工血管旁路术患者40例,年龄67 ～ 81岁,体重47～65 kg,ASA分级Ⅱ级或Ⅲ级,采用随机数字表法,将其分为2组（n=20）：脊麻组（S组）和腰丛神经阻滞组（L组）.S组蛛网膜下腔注射0.5％重比重罗哌卡因3ml;L组在神经刺激仪引导下行腰丛神经阻滞,注射0.5％罗哌卡因30 ml.记录感觉阻滞起效时间、维持时间及麻醉效果,记录术中麻黄碱使用情况、输液量及腰丛神经阻滞相关不良事件发生情况.结果 与S组比较,L组感觉阻滞起效时间和维持时间延长,麻黄碱使用率和输液量降低（P＜0.05）,麻醉效果差异无统计学意义（P＞0.05）.L组未见腰从神经阻滞相关不良事件.结论 腰丛神经阻滞用于老年患者单侧股动脉-股深动脉人工血管旁路术是可行的.Objective To evaluate the feasibility of using lumbar plexus block for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.Methods Forty ASA physical status Ⅱ or Ⅲ patients,aged 67-81 yr,weighing 47-65 kg,scheduled for extremity artificial vascular graft between femoral artery and deep femoral artery,were randomly divided into 2 groups （n =20 each） using a random number table：spinal anesthesia group （group S） and lumbar plexus block group （group L）.In group S,0.5 % hyperbaric ropivacaine 3 ml was injected into the subarachnoid space.In group L,lumbar plexus block was performed with 30 ml of 0.5 % ropivacaine under the guidance of a nerve stimulator.The onset time and duration of sensory block,anesthetic efficacy,and requirement for ephedrine and volume of fluid infused during operation,and development of lumbar plexus block-related adverse events were recorded.Results Compared with group S,the onset time and duration of sensory block were significantly prolonged,the requirement for ephedrine and volume of fluid infused during operation were decreased,and no significant change was found in anesthetic efficacy in group L.No lumbar plexus block-related adverse events developed in group L.Conclusion Lumbar plexus block can be used for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.

关 键 词：神经传导阻滞 腰骶丛 血管外科手术 股动脉 老年人 

分 类 号：R614[医药卫生—麻醉学]