超声下股神经-股外侧皮神经联合阻滞麻醉对髌骨骨折患者阻滞效果及血流动力学的影响  

Effect of combined femoral nerve-lateral femoral cutaneous nerve block anesthesia under ultrasound on the block effect and hemodynamics in patients with patellar fracture

作　　者：李君[1] 惠志成 LI Jun;HUI Zhicheng(Department of Anesthesiology,Dalian Hospital of Shengjing Hospital of China Medical University,Dalian,Liaoning,116600,China;Department of Anesthesiology,Dalian Third People's Hospital,Dalian,Liaoning,116600,China)

机构地区：[1]中国医科大学附属盛京医院大连医院麻醉科,辽宁大连116600 [2]大连市第三人民医院麻醉科,辽宁大连116600

出　　处：《当代医学》2023年第21期37-40,共4页Contemporary Medicine

摘　　要：目的探讨超声下股神经-股外侧皮神经联合阻滞麻醉在髌骨骨折患者中的应用效果。方法选取2019年7月至2020年7月本院收治的82例髌骨骨折患者作为研究对象,按照随机数字表法分为对照组与观察组,每组41例。对照组予以硬膜外麻醉,观察组给予超声下股神经-股外侧皮神经联合阻滞麻醉,比较两组阻滞效果、血流动力学、疼痛程度、不良反应发生率。结果观察组感觉阻滞起效时间、持续时间均长于对照组,感觉阻滞完善时间短于对照组,运动阻滞起效时间、完善时间、持续时间均短于对照组,差异有统计学意义(P<0.05)。两组舒张压(DBP)、收缩压(SBP)组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:对照组DBP、SBP麻醉后各时间点均低于前一时间点,差异有统计学意义(P<0.05);T1、T2、T3时,观察组DBP均低于T0、T4时,且T1时低于T3时,差异有统计学意义(P<0.05);T1、T2、T3、T4时,观察组SBP均低于T0时,T2时低于T1、T4时,差异有统计学意义(P<0.05);两组DBP、SBP组内其他时间点两两比较差异无统计学意义。组间比较:T0时,两组DBP、SBP比较差异无统计学意义;T1、T2、T3、T4时,观察组DBP、SBP均高于对照组,差异有统计学意义(P<0.05)。两组视觉模拟评分法(VAS)评分组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:术后4、6 h,两组VAS评分均高于术后2 h,且术后6 h高于术后4 h,差异有统计学意义(P<0.05)。组间比较:术后2、4、6 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论超声下股神经-股外侧皮神经联合阻滞麻醉在髌骨骨折患者中阻滞效果确切,对血流动力学影响较小,术后疼痛较轻,且可减少不良反应,安全性较高。Objective To explore the application effect of combined femoral nerve-lateral femoral cutaneous nerve block anesthesia under ultrasound in patients with patellar fractures.Methods 82 patients with patellar fractures admitted to our hospital from July 2019 to July 2020 were selected as the study subjects,they were divided into the control group and the observation group according to the random number table method,with 41 cases in each group.The control group received epidural anesthesia,while the observation group received combined femoral nerve-lateral femoral cutaneous nerve block anesthesia under ultrasound,the block effect,hemodynamics,degree of pain,and incidence of adverse reactions were compared between the two groups.Results The onset time and duration of sensory block in the observation group were longer than those in the control group,the completion time of sensory block was shorter than that in the control group,and the onset time,completion time and duration of motor block were shorter than those in the control group,the differences were statistically significant(P<0.05).There were significant differences among diastolic blood pressure(DBP)and systolic blood pressure(SBP)between the two groups of groups,time points and interaction(P<0.05).Comparison within the group:at T1,T2 and T3,DBP in the observation group was lower than that at T0 and T4,and T1 was lower than T3,the differences were statistically significant(P<0.05);at T1,T2,T3 and T4,SBP in the observation group was lower than that at T0,and T2 was lower than that at T1 and T4,and the differences were statistically significant(P<0.05);there was no statistically significant difference in DBP and SBP at other time points within the group between the two groups.Comparison between groups:at T0,there was no significant difference in DBP and SBP between the two groups;at T1,T2,T3 and T4,DBP and SBP in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were significant diffe

关 键 词：髌骨骨折 股神经-股外侧皮神经 血流动力学 不良反应 

分 类 号：R683.42[医药卫生—骨科学]