超声引导下连续股神经阻滞联合喉罩下全麻与硬膜外阻滞复合喉罩下全麻用于全膝关节置换术的效果比较  

Effect comparison between ultrasound guided continuous femoral nerve block combined with laryngeal mask anesthesia and continuous epidural block combined with laryngeal mask anesthesia in treatment of patients with total knee replacement

作　　者：胡小雪 金忆 许明岚 

机构地区：[1]上海市光华中西医结合医院麻醉科,上海200052

出　　处：《实用临床医药杂志》2014年第21期64-66,共3页Journal of Clinical Medicine in Practice

摘　　要：目的比较超声引导下连续股神经阻滞联合喉罩全麻与连续硬膜外阻滞复合喉罩全麻用于全膝关节置换术的效果。方法择期行全膝关节置换术的类风湿性关节炎和骨关节炎造成的膝关节破坏患者60例,采用随机数字表法分为2组。I组超声引导行连续股神经阻滞联合喉罩下全麻,Ⅱ组在连续硬膜外阻滞复合喉罩下全麻。记录术中和PACU停留期间的生命体征用药情况。记录术后48 h内PAC药物用量和恶心呕吐、低血压的发生情况,术后VAS评分和患者总体满意度评价。结果2组一般资料比较无显著差异(P>0.05),2组患者术后6 h、12 h、24 h、48 h VAS评分比较无显著差异(P>0.05)。Ⅰ组术中截骨后即刻平均动脉压、心率与Ⅱ组比较有显著差异(P<0.05),其他效果基本一致,Ⅱ组术后恶心呕吐,低血压发生率比I组高(P<0.05)。结论两种方式均能满足术后镇痛需要,但I组并发症少、风险低,操作简单直观,患者舒适度高。Objective To compare the effect of ultrasound guided continuous femoral nerve block combined with laryngeal mask anesthesia and continuous epidural block combined with laryngeal mask anesthesia on treatment of patients with total knee replacement. Methods 60 patients receiving knee arthroplasty caused by rheumatoid arthritis and osteoarthritis were randomly divided into 2 groups （n = 30） by random number table. Group Ⅰ received ultrasound guided continuous femoral nerve block combined with laryngeal mask anesthesia, and the patients received postoperative analgesia by continuous femoral nerve block and electronic analgesia pump of Chinese production （Group PCFN）. Group Ⅱ was applied with continuous epidural block combined with laryngeal mask anesthesia, and the patients received postoperative analgesia by continuous epidural anesthesia and the same electronic analgesia pump （Group PCEA）. Postoperative analgesia lasted for 48 hours in both groups. Vital sign during the operation and postoperative recovery were recorded. PCA dosage, visual analogue scale （VAS） scores in 48 hours after operation, nausea, vomiting, hypotension and patients＇ satisfaction were recorded. Results There was no significant difference in the material of the patients and VAS scores of 6 hours, 12 hours, 24 hours, 48 hours between the two groups （P 〉0.05）. The mean arterial pressure and heart rate between two groups showed significant difference （P 〈 0.05）. The incidence rates of postoperative nausea, vomiting and hypotension in group Ⅱ were higher than group Ⅰ （P 〈 0.05）. Conclusion Both methods can achieve good effect of postoperative analgesia, and the patients in group I have fewer complications, lower risk.

关 键 词：股神经阻滞 硬膜外阻滞 复合喉罩插管 膝关节置换 

分 类 号：R687.4[医药卫生—骨科学]