超声联合神经刺激器引导神经阻滞在后入路髋臼骨折手术中的应用  

Application of ultrasound combined with nerve stimulator guided nerve block in posterior approach acetabular fracture surgery

作　　者：陈超 樊龙昌[1] 杨曙光 梅伟[1] CHEN Chao;FAN Long-chang;YANG Shu-guang;MEI Wei(Department of Anesthesiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,武汉430030

出　　处：《骨科》2021年第1期63-67,共5页ORTHOPAEDICS

基　　金：湖北省科技计划项目(2019CFB445)。

摘　　要：目的观察及评价超声联合神经刺激器引导神经阻滞用于髋臼骨折后入路手术麻醉的可行性。方法选择2017年11月至2019年9月于我院行髋臼骨折后入路手术的病人11例,于超声引导下行T12椎旁+腰丛+第1骶后孔神经阻滞麻醉,评估麻醉效果,记录病人神经阻滞前、切皮前、切皮时、手术开始后10 min的心率(HR)、收缩压(SBP)、舒张压(DBP),记录局麻药中毒等阻滞相关的不良反应。结果所有病人均取得满意的麻醉效果,麻醉效果评价:优72.7%,良27.3%。神经阻滞前、切皮前、切皮时、手术开始后10 min各时间点HR、SBP、DBP的差异均无统计学意义(P均>0.05)。所有病人均未出现局麻药中毒等阻滞相关不良反应。结论超声联合神经刺激器引导神经阻滞可用于髋臼骨折后入路手术病人的临床麻醉。Objective To evaluate the effectiveness of ultrasound combined with nerve stimulator guided nerve block in posterior approach acetabular fracture surgery.Methods Eleven patients who received posterior approach acetabular fracture surgery from November 2017 to September 2019 in our hospital were prospectively collected,they were given a combination of lumbar plexus block and 12th parathoracic and 1st posterior sacral foramina nerve block guided by ultrasound.The quality of surgical analgesia was evaluated,and heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)were recorded pre⁃anesthesia,pre⁃incision,on incision and 10 min post⁃incision.All nerve blockade⁃related adverse events including local anesthetic⁃related toxicity were recorded.Results Satisfied surgical analgesia was reported by all patients.For anesthesia effect rating,72.7%was excellent and 27.3%was good.There was no significant difference in HR,SBP,DBP measured pre⁃anesthesia,pre⁃incision,on incision and 10 min post⁃incision.No nerve blockade⁃related adverse event was observed.Conclusion Ultrasound combined with nerve stimulator guided nerve block can provide adequate surgical analgesia for patients undergoing posterior acetabular fracture surgery.

关 键 词：超声 神经阻滞 髋臼骨折 椎旁 骶丛 

分 类 号：R614[医药卫生—麻醉学]