单次注射法与双次注射法行坐骨神经阻滞效果的比较  

Comparison of single-versus double-injection techniques forsciatic nerve block

作　　者：桂晓臣[1] 张华[1] 李平[1] 王辉[1] 蒋文臣[1] 

机构地区：[1]天津市天津医院麻醉科,300221

出　　处：《中华麻醉学杂志》2015年第2期197-199,共3页Chinese Journal of Anesthesiology

摘　　要：目的 比较单次注射法与双次注射法行坐骨神经阻滞的效果.方法 择期行单侧足踝手术患者60例,ASA分级Ⅰ或Ⅱ级,性别不限,年龄18 ～ 64岁,体重48～72 kg,采用随机数字表法,将其分为2组（n=30）：单次注射组（S组）和双次注射组（D组）.采用Labat-winnie入路在神经刺激仪引导下行坐骨神经阻滞.S组出现背屈或跖屈时,注射0.5％罗哌卡因30 ml;D组出现背屈和跖屈时,各注射0.5％罗哌卡因15 ml.记录定位失败情况.记录操作完成时间、感觉阻滞和运动阻滞起效及维持时间、总的阻滞时间.评估坐骨神经阻滞情况.结果 D组定位失败率为10％.S组阻滞成功率为93％,D组阻滞成功率为96％,2组阻滞成功率比较差异无统计学意义（P＞0.05）.与S组比较,D组感觉阻滞和运动阻滞起效时间缩短,操作完成时间延长（P＜0.05）,总的阻滞时间、感觉阻滞和运动阻滞维持时间差异无统计学意义（P＞0.05）.结论 下肢手术患者行坐骨神经阻滞时推荐采用单次注射局麻药.Objective To compare the single-and double-injection techniques for sciatic nerve block.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 48-72 kg,undergoing elective unilateral foot and ankle surgery,were randomly divided into 2 groups （n =30 each） using a random number table：single-injection group （group S） and double-injection group （group D）.Labat-winnie approach to sciatic nerve block was performed under the guidance of a nerve stimulator.When ankle dorsal or plantar flexion developed,group S received a single injection of 0.5% ropivacaine 30 ml.When ankle dorsal and plantar flexion developed,0.5% ropivacaine 15 ml was injected each time in group D.The failure of location was recorded.The time spent performing the procedure,onset time and duration of sensory and motor blockade,and the total time for the block were recorded.The effectiveness of block （success,failure） was assessed.Results The failure rate of location was 10% in group D.The success rate of block was 93% in group S,and was 96% in group D,and there was no significant difference in the success rate of block between the two groups.Compared with group S,the onset time of sensory and motor blockade was significantly shortened,the time spent performing the procedure was prolonged,and no significant change was found in the total time for the block,duration of sensory and motor blockade in group D.Conclusion Single-injection technique is recommended for the sciatic nerve block in the patients undergoing lower extremity surgery.

关 键 词：神经传导阻滞 坐骨神经 

分 类 号：R614[医药卫生—麻醉学]