超声引导下坐骨神经不同阻滞部位对足部手术患者麻醉效果的影响  

Effect of different block sites of sciatic nerve under ultrasound guidance on anesthesia effect of patients undergoing foot surgery

作　　者：蔡文博 郝建红 张洁[1] 罗振国 董补怀[1] 易双强 CAI Wen-bo;HAO Jian-hong;ZHANG Jie;LUO Zhen-guo;DONG Bu-huai;YI Shuang-qiang(Department of Anesthesiology,Red Cross Society Hospital Affiliated to Xi’an Jiaotong University,Xi'an 710054,Shaanxi,CHINA)

机构地区：[1]西安交通大学附属红会医院麻醉科,陕西西安710054

出　　处：《海南医学》2020年第24期3198-3201,共4页Hainan Medical Journal

摘　　要：目的探讨超声引导下坐骨神经不同阻滞部位对足部手术患者麻醉效果的影响。方法选取西安交通大学附属红会医院2018年1月至2019年12月收治的100例足部手术患者为研究对象,按照随机数表法将患者分为观察组和对照组,每组50例。观察组患者给予胫、腓总神经阻滞,对照组给予坐骨神经阻滞。比较两组患者的麻醉阻滞成功率、穿刺时间、成像时间、操作时间、运动阻滞完善时间、神经感觉时间及不良反应发生率情况。结果两组患者的胫神经阻滞完全率、腓总神经阻滞完全率、穿刺时间、成像时间及操作时间比较差异均无统计学意义(P>0.05);观察组患者的胫神经运动、腓总神经运动、胫神经感觉、腓总神经感觉阻滞完善时间分别为(17.26±3.14)min、(16.84±2.72)min、(9.05±1.37)min、(8.39±1.53)min,明显短于对照组的(21.52±4.37)min、(21.37±3.83)min、(11.39±2.61)min、(11.45±2.72)min,差异均有统计学意义(P<0.05);两组患者治疗过程中及出院一周后随访,均无不良反应发生。结论超声引导下坐骨神经阻滞与超声引导下胫、腓总神经阻滞均对足部手术患者的阻滞成功率、操作性及安全性有较好效果,但胫、腓总神经阻滞患者的运动、总神经感觉阻滞完善时间更短,临床治疗中应谨慎选择合理阻滞部位。Objective To investigate the influence of different block sites of sciatic nerve under ultrasound guidance on anesthesia effect of patients undergoing foot surgery.Methods A total of 100 patients with foot surgery,who admitted to Red Cross Society Hospital Affiliated to Xi'an Jiaotong University from January 2018 to December 2019,were selected and divided into the observation group and control group according to random number table method,with 50 patients in each group.The observation group was given tibial and peroneal nerve block,and then the control group was given sciatic nerve block.Anesthesia block success rate,puncture time,imaging time,operation time,motor block improvement time,nerve sensation time,and incidence of adverse reactions were compared between the two groups.Results There was no significant difference in tibial nerve block complete rate,common peroneal nerve block complete rate,puncture time,imaging time,and operation time between the two groups(all P>0.05);the tibial nerve movement,common peroneal nerve movement,tibial nerve sensation,and common peroneal nerve sensory block perfection time of the observation group were(17.26±3.14)min,(16.84±2.72)min,(9.05±1.37)min,(8.39±1.53)min,respectively,which were significantly shorter than corresponding(21.52±4.37)min,(21.37±3.83)min,(11.39±2.61)min,(11.45±2.72)min in the control group(all P<0.05);during the treatment of the two groups and one week after discharge,no adverse reactions occurred.Conclusion Both ultrasound-guided sciatic nerve block and ultrasound-guided tibial and common peroneal nerve block have good effects on the success rate,operability,and safety of patients undergoing foot surgery,but the motor and general nerve sensory block perfection time of patients with tibial and peroneal nerve block are shorter.The reasonable block site should be carefully selected in clinical treatment.

关 键 词：足部手术 超声 坐骨神经阻滞 腓神经 胫神经 麻醉效果 

分 类 号：R614.3[医药卫生—麻醉学]