超声辅助下细针腰麻技术在老年下肢骨科手术中的应用  

Application of Fine Needle Lumbar Anesthesia Technique Assisted by Ultrasound in Lower Limb Orthopedic Surgery of Elderly Patients

作　　者：李长松[1] 李小静[1] 朱雅斌[1] 吉晓丽[1] 袁志国[1] 徐玉民[1] 宋后恩 孙灿林[1] LI Chang-song;LI Xiao-jing;ZHU Ya-bin;JI Xiao-li;YUAN Zhi-guo;XU Yu-min;SONG Hou-en;SUN Can-lin(Taizhou People’s Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]泰州市人民医院,江苏泰州225300

出　　处：《泰州职业技术学院学报》2020年第3期51-53,56,共4页Journal of Taizhou Polytechnic College

摘　　要：目的研究在超声辅助下应用25G Whitacre腰麻针不同节段单次腰麻对老年患者下肢骨科手术的应用效果。方法选取2018年5月至2019年12月入住我院需行下肢骨科手术的80例老年患者,随机分为2组:M组(n=40),穿刺点选腰2~3椎间隙;N组(n=40),穿刺点选腰3~4椎间隙。两组患者在超声辅助下使用25G Whitacre腰麻针行正中入路穿刺。记录两组患者腰麻穿刺情况、麻醉效果及术后情况。结果M组麻醉结果明显优于N组(P<0.05);需更换麻醉穿刺操作者的例数和麻醉阻滞不全的例数M组明显少于N组(P<0.05);术中及术后并发症例数两组间无明显差异(P>0.05)。结论对下肢骨科手术的老年患者在超声辅助下使用25G Whitacre腰麻针行腰2~3椎间隙单次腰麻,成功率高,效果明确,是更利于操作的穿刺间隙选择。Objective To investigate the application of 25G Whitacre lumbar acupuncture assisted by ultrasound in the treatment of elderly patients with lower extremity orthopedic surgery with single lumbar anesthesia at dif⁃ferent segments.Methods 80 elderly patients admitted to our hospital from May 2018 to December 2019 for lower limb surgery were randomly divided into 2 groups:Group M(n=40),the lumbar 2~3 intervertebral space was used as the puncture point,Group N(n=40),the lumbar 3~4 intervertebral space was used as the puncture point.Patients in both groups were placed on the lateral supine position to expose the puncture range.The 25G Whitacre lumbar hemp needle was used with ultrasound assistance and median ap⁃proach puncture was adopted.The puncture condition,anesthetic effect and postoperative status of the two groups were recorded.Results The puncture time,puncture times and anesthesia elevation of Group M were significantly better than that of Group N(P<0.05).The number of cases requiring replacement and the number of cases with incomplete anesthesia block in Group M was significantly less than that in Group N(P<0.05).There was no significant difference between the two groups in the number of cases requiring the use of vasoac⁃tive drugs during the operation,the number of cases of heteresthesia during the operation,PONV,headache,lumbago and neurological complications after the operation(P>0.05).Conclusion For elderly patients undergo⁃ing lower extremity orthopaedic surgery,25G Whitacre lumbar hemp needle was used under the assistance of ul⁃trasound for a single lumbar anesthesia in the lumbar 2~3 intervertebral space,which has a high success rate and clear effect,and is a more favorable choice for puncture clearance.

关 键 词：超声辅助 细针 单次腰麻 下肢骨科 老年患者 

分 类 号：R614.4[医药卫生—麻醉学]