神经刺激仪引导下腰丛+坐骨神经+股外侧皮神经联合阻滞用于PFNA术的临床研究  

Clinical study on application of combined block of lumbar plexus nerve, sciatic nerve and lateral femoral cutaneous nerve guided by nerve stimulator in PFNA

作　　者：吴春林[1] 张光旭 潘刘生 张天明[1] 梁集玲[1] 谭嘉颖 WU Chunlin;ZHANG Guangxu;PAN Liusheng;ZHANG Tianming;LIANG Jiling;TAN Jiaying(Department of Anesthesia and Surgery,Xinyi People’s Hospital,Xinyi 525300,China)

机构地区：[1]广东省信宜市人民医院麻醉手术科

出　　处：《中国医药科学》2019年第20期98-101,共4页China Medicine And Pharmacy

基　　金：广东省茂名市科技计划项目（180321081704667）

摘　　要：目的对股骨粗隆间骨折闭合复位防旋髓内钉内固定术(PFNA术)中应用神经刺激仪引导下腰丛+坐骨神经+股外侧皮神经联合阻滞的效果进行探讨。方法选取本院2018年1~12月期间120例PFNA术患者进行研究,随机分为观察组与对照组,各60例,对照组采用神经刺激仪引导下腰丛+坐骨神经阻滞麻醉,观察组应用神经刺激仪引导下腰丛+坐骨神经+股外侧皮神经联合阻滞,对两组患者术前、术中及术后不同时间点血流动力学变化及麻醉操作时间、舒芬太尼使用量及镇痛效果进行比较。结果与对照组比较,术前、麻醉后及术后不同时间点观察组DBP、SBP、P及SpO2水平稳定,两组差异无统计学意义(P>0.05);在麻醉操作时间,观察组长于对照组,差异有统计学意义(P<0.05);术中舒芬太尼使用量方面,观察组少于对照组,差异有统计学意义(P<0.05);镇痛优良率方面,对照组(88.33%)低于观察组(100%),差异有统计学意义(P<0.05);在不良反应方面,观察组为2.78%,对照组为2.78%,两组差异无统计学意义(P>0.05)。结论PFNA术中应用神经刺激仪引导下腰丛+坐骨神经+股外侧皮神经联合阻滞,麻醉效果优良率高,对患者血流动力学影响小,对患者机体生理功能影响较小,尤其在伴有基础疾病较多的高龄患者中应用价值较高。Objective The explore the curative effects of application of combined block of lumbar plexus nerve,sciatic nerve and lateral femoral cutaneous nerve guided by nerve stimulator in proximal femoral nail anti-rotation(PFNA)for patients with intertrochanteric fracture closed reduction.Methods One hundred and twenty patients who underwent PFNA in our hospital from January 2018 to December 2018 were selected.They were randomly divided into the observation group and the control group,with 60 cases in each group.The control group was given block anesthesia of lumbar plexus nerve and sciatic nerve guided by nerve stimulator while the observation group was given combined block of lumbar plexus nerve,sciatic nerve and lateral femoral cutaneous nerve guided by nerve stimulator.The hemodynamic changes,anesthesia operation time,dosage of sufentanil and analgesic effect before operation,during operation and at different time points after operation were compared between the two groups.Results Compared with the control group,the levels of DBP,SBP,P and SpO2 in the observation group were more stable before operation,after anesthesia and at different time points after operation.There was no statistically significant difference between the two groups(P>0.05).The anesthesia operation time of the observation group was longer than that of the control group,and the difference was statistically significant(P<0.05).Dosage of sufentanil during the operation in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).The excellent rate of analgesia of the control group was 88.33%,lower than that of the observation group(100%),and the difference was statistically significant(P<0.05).Adverse reaction of the observation group was 2.78%and that of the control group was 2.78%.There was no significant difference between the two groups(P>0.05).Conclusion Application of combined block of lumbar plexus nerve,sciatic nerve and lateral femoral cutaneous nerve guided by nerve stimulator in P

关 键 词：PFNA术 神经刺激仪 腰丛神经阻滞 坐骨神经阻滞 股外侧皮神经阻滞 

分 类 号：R683.4[医药卫生—骨科学] R614.4[医药卫生—外科学]