神经刺激器定位下椎旁-坐骨神经联合阻滞在老年患者下肢手术中的麻醉效果研究  

Study on the Anesthetic Effect of Combined Spinal-Epidural Anesthesia of Paravertebral Sciatic Nerve Assisted with Nerve Stimulator in the Leg Surgery of Elderly Patients

作　　者：谢长春[1] 黄建辉[1] 付建强[1] 钟启钊[1] 陈旭[1] XIE Changchun HUANG Jianhui FU Jianqiang ZHONG Qizhao CHEN Xu(Department of A nesthesia, Liwan Hospital of Cuangzhou Medical University, Guangzhou 510170, China)

机构地区：[1]广州医科大学荔湾医院麻醉科,广东广州510170

出　　处：《临床医学工程》2017年第8期1063-1064,共2页Clinical Medicine & Engineering

摘　　要：目的研究神经刺激器定位下椎旁-坐骨神经联合阻滞在老年患者下肢手术中的麻醉效果。方法选择行下肢手术的40例老年患者作为研究对象,随机分为两组各20例。对照组采用硬膜外麻醉,观察组采用神经刺激器定位下椎旁-坐骨神经联合阻滞。结果与对照组相比,观察组术后6 h、术后12 h、术后24 h的VAS评分明显更低,BCS评分明显更高(P<0.05)。观察组的不良反应发生率为10%,显著低于对照组的40%(P<0.05)。观察组术后6 h的双下肢运动功能状态显著优于对照组(P<0.05)。麻醉后20 min、25 min、30 min,观察组的HR和MAP与麻醉前相比无显著改变(P>0.05),而对照组的HR显著升高,MAP显著降低(P<0.05)。结论神经刺激器定位下椎旁-坐骨神经联合阻滞在老年患者下肢手术中的麻醉效果显著,不良反应少。Objective To study the anesthetic effect of combined spinal-epidural anesthesia of paravertebral sciatic nerve assisted with nerve stimulator in the leg surgery of elderly patients. Methods 40 cases of elderly patients with leg surgery were randomly divided into two groups equally. The control group received epidural anesthesia, while the observation group received combined spinal-epidural anesthesia ofparavertebral sciatic nerve assisted with nerve stimulator. Results Compared with the control group, the observation group had significantly lower VAS score and higher BCS score at 6, 12 and 24 h after surgery （P〈0.05）. The incidence of adverse reactions of observation group was 10%, significantly lower than 40% of control group （P 〈O.05）. At 6 b after surgery, the motor function of lower extremities of observation group was significantly better than that of control group （P〈0.05）. At 20 min, 25 min, 30 min of anesthesia, the MAP and HR of observation group had no statistical change compared with those befoer anesthesia （P〉0.05）, while in the control group, the MAP decreased significantly and the HR increased significantly （P 〈0.05）. Conclusions Combined spinal-epidural anesthesia of paravertebral sciatic nerve assisted with nerve stimulator in the leg surgery of elderly patients has significant anesthetic effect, with few adverse reactions.

关 键 词：神经刺激器定位器 椎旁-坐骨神经联合阻滞 老年患者 下肢手术 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]