超声引导下股神经阻滞复合喉罩全麻对全膝关节置换术患者的影响  

Effects of Ultrasound Guided Femoral Nerve Block Combined with Laryngeal Mask Airway in Patients Undergoing Total Knee Arthroplasty

作　　者：叶秀红[1] 唐华东[1] 林志坚[1] 

机构地区：[1]福建医科大学附属漳州市医院麻醉科,福建漳州363000

出　　处：《中外医疗》2016年第27期14-16,共3页China & Foreign Medical Treatment

摘　　要：目的研究超声引导下股神经阻滞复合喉罩全麻对全膝关节置换术患者的影响。方法方便选取从2013年4月—2016年1月,于该院接受全膝关节置换术患者60例,以数字法随机分为观察组及对照组各30例。两组均给予常规麻醉,在全麻诱导后观察组行复合超声定位下股神经阻滞。术后所有患者均给予静脉自控镇痛(PCA)。对比两组麻醉诱导前(T1)、插管后即刻(T2)、切皮时(T3)和术毕拔管即刻(T4)的MAP和HR,术后2、4、8 h VAS评分以及PCA按压次数,术中丙泊酚和瑞芬太尼用量。结果 T3、T4时观察组MAP值为(82.6±2.9)、(80.4±3.2)mm Hg,HR值为(77.8±6.3)、(76.3±6.8)bmp;均显著低于对照组的(90.4±3.6)、(87.1±3.5),(90.3±5.7)mm Hg、(85.6±6.9)bmp。观察组患者术后2、4、8 h VAS评分和PCA按压次数均明显低于对照组;观察组患者术中丙泊酚和瑞芬太尼用量显著低于对照组,上述差异有统计学意义(P<0.05)。结论超声引导下股神经阻滞复合喉罩全麻能有效减少接受全膝关节置换术患者全麻药用量,循环更加稳定,并能减轻患者术后疼痛,加速康复。Objective To study the ultrasound guidance of femoral nerve block combined with laryngeal mask anesthesia for total knee arthroplasty patients affected. Methods Convenient selection from April 2013 to January 2016, 60 patients with total knee arthroplasty were randomly divided into observation group and control group with 30 cases in each group.Two groups were given routine anesthesia. After induction of general anesthesia in the observation group was treated with compound ultrasonic location of femoral nerve block. After operation all patients were given intravenous patient-controlled analgesia（PCA）.Compared the two groups before induction of anesthesia（T1）, immediately after intubation（T2）, cutting the skin（T3） and immediately after extubation（T4） MAP and HR, 2、4、8 h VAS score and PCA compression times, intraoperative propofol and remifentanil dosage.Results T3, T4 observation group MAP value was（82.6 ± 2.9） mm Hg,（80.4 ± 3.2）mm Hg,HR value was（77.8 ± 6.3） bmp,（76.3 ± 6.8） bmp, were significantly lower than the control group（90.4 ± 3.6）mm Hg,（87.1 ± 3.5） mm Hg,（90.3 ± 5.7） bmp,（85.6 ± 6.9） bmp.Observation group patients after 2,4,8 h VAS score and PCA pressing times were significantly lower than those in the control group;observation group patients and the dosage of propofol and remifentanil was significantly lower than that of the control group. The above differences were statistically significant（P〈0.05）. Conclusion Ultrasound guided femoral nerve block combined with laryngeal mask anesthesia can effectively reduce accepted total knee arthroplasty in patients with general anesthetics dosage, cycle more stability and reduce postoperative pain,accelerated rehabilitation.

关 键 词：超声引导 股神经阻滞 喉罩全麻 全膝关节置换术 

分 类 号：R614[医药卫生—麻醉学]