老年下肢手术中腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉的效果及血流动力学比较  

Lumbar Plexus-Sciatic Nerve Blocks and Combined Spinal and Epidural Analgesia for Lower Limb Surgery in Elderly Patients:Comparison of Anesthetic Effect and Hemodynamics

作　　者：韩琪[1] 廖永强[1] 李荣胜[1] 于霖[1] 邓庆丰[1] 郭庆聪 郭兆麟[1] 谢华杰[1] 王景坤[1] 

机构地区：[1]东莞市人民医院麻醉科,广东东莞523000

出　　处：《实用临床医学（江西）》2017年第5期38-40,共3页Practical Clinical Medicine

摘　　要：目的比较老年下肢手术中腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉的效果及对血流动力学指标的影响。方法按照不同麻醉方式将82例老年下肢手术患者分为试验组42例和对照组40例,试验组接受腰丛-坐骨神经阻滞麻醉,对照组接受腰硬联合麻醉,比较2组麻醉效果。结果试验组麻醉良好率显著高于对照组(P<0.05);2组患者麻醉即刻(t0)、麻醉后10min(t1)、麻醉后30min(t2)、麻醉后1h(t3)血流动力学指标[平均动脉压(MAP)、心率(HR)、动脉血氧饱和度(SpO_2)]均未发生明显改变,组内和组间比较,差异均无统计学意义(均P>0.05);试验组患者感觉神经阻滞和运动神经阻滞起效时间及维持时间均显著长于对照组(P<0.05);试验组患者术中不良反应发生率均显著低于对照组(P<0.05)。结论老年下肢手术中行腰丛-坐骨神经阻滞麻醉效果比腰硬联合麻醉更佳,对患者血流动力学指标影响小,不良反应少。Objective To compare the anesthetic efficacies of lumbar plexus-sciatic nerve blocks and combined spinal and epidural analgesia for lower limb surgery and their influences on hemodynamic indexes in elderly patients.Methods A total of 82 elderly patients were assigned to receive either lumbar plexus-sciatic nerve blocks(experimental group,n=42)or combined spinal and epidural analgesia(control group,n=40)for lower limb surgery.The anesthetic efficacies were compared between the two groups.Results The good rate of anesthesia in experimental group was higher than that in control group(P<0.05).There were no significant differences in mean arterial pressure,heart rate and arterial oxygen saturation between the two groups immediately after anesthesia and 10 minutes,30 minutes and 1hour after anesthesia(P>0.05).Compared with control group,the onset time and maintenance time of sensory and motor nerve blocks were prolonged and the incidence of adverse reactions was decreased in experimental group(P<0.05).Conclusion Compared with combined spinal and epidural analgesia,lumbar plexus-sciatic nerve blocks for lower limb surgery can improve hemodynamics and reduce adverse reactions in elderly patients.

关 键 词：下肢手术 腰丛-坐骨神经阻滞麻醉 腰硬联合麻醉 老年患者 

分 类 号：R614.4[医药卫生—麻醉学]