股神经联合收肌管隐神经阻滞在大隐静脉曲张剥脱术中的麻醉效果  

The Anesthesia Effect of Femoral Nerve Combined with Adductor Canal and Saphenous Nerve Block in Varicocele Dissection of the Great Saphenous Vein

作　　者：龙伟 徐丽华 曹慧灵[1] 谢科宇[1] 王立维 LONG Wei;XU Lihua;CAO Huiling;XIE Keyu;WANGLiwei(Department of Anesthesiology,Chengdu Second People's Hospital,Chengdu 610000,China;Department of Thyroid and Breast Vascular Surgery,Chengdu Second People's Hospital,Chengdu 610000,China)

机构地区：[1]成都市第二人民医院麻醉科,成都610000 [2]成都市第二人民医院甲状腺乳腺血管外科,成都610000

出　　处：《宁夏医科大学学报》2024年第11期1127-1131,共5页Journal of Ningxia Medical University

基　　金：四川省卫健委普及应用项目(21PJ140)。

摘　　要：目的观察股神经联合收肌管隐神经阻滞在大隐静脉曲张剥脱术中的麻醉效果。方法选取2023年1月至2023年7月于成都市第二人民医院行大隐静脉曲张剥脱术患者98例,将98例患者随机分为观察组(n=49)和对照组(n=49),观察组给予股神经联合收肌管隐神经阻滞,对照组给予椎管内麻醉,比较两组患者麻醉效果、手术时间、使用镇痛镇静药物等情况。结果观察组麻醉操作时间、感觉阻滞起效时间长于对照组(P均<0.05);观察组使用血管活性药物比例低于对照组(P<0.05);观察组术后首次下床活动时间早于对照组(P<0.05),而术后住院时间和住院费用均低于对照组(P均<0.05);对照组麻醉后5、10、30 min的收缩压(SBP)与麻醉前比较有所波动(P均<0.05),而舒张压(DBP)和心率(HR)较平稳(P均>0.05),观察组麻醉后5、10、30 min的SBP、DBP和HR与麻醉前比较均较平稳(P均>0.05);观察组术后12 h和24 h时VAS评分低于对照组(P均<0.05);观察组发生尿潴留比例低于对照组(P<0.05)。结论大隐静脉曲张剥脱术中复合神经阻滞方案有较好的临床应用价值,有助于稳定术中血流动力学。Objective To observe the anesthesia effect of femoral nerve combined with adductor canal and saphenous nerve block in varicocele dissection of the great saphenous vein.Methods A total of 98 patients who underwent great saphenous vein variceal exfoliation surgery from January 2023 to July 2023 were selected.The patients were randomly divided into an observation group(n=49)and a control group(n=49)using a random number table method.The observation group received femoral nerve combined with adductor canal saphenous nerve block,while the control group received spinal anesthesia.The differences in anesthesia effect,surgical time,and use of analgesics and sedatives between the two groups were observed.Results The anesthesia operation time,onset time of sensory blockade in the observation group was more than that in the control group(P all<0.05).The proportion of using vasoactive drugs in the observation group was lower than that in the control group(P<0.05).The first postoperative ambulation time in the observation group was earlier than that in the control group(P<0.05).The postoperative hospitalization time and cost were lower than those in the control group(P all<0.05).The systolic blood pressure(SBP)of the control group fluctuated before anesthesia,5 minutes,10 minutes,and 30 minutes after anesthesia(P<0.05),while diastolic blood pressure(DBP)and heart rate(HR)were relatively stable(P all>0.05).The VAS scores of the observation group at 12 and 24 h after surgery was lower than those of the control group(P<0.05).The incidence of urinary retention in the observation group was lower than that in the control group(P<0.05).Conclusion The composite nerve block scheme during the varicose vein dissection surgery has good clinical application value and helps stabilize intraoperative hemodynamics.

关 键 词：大隐静脉曲张剥脱术 股神经 收肌管隐神经阻滞 

分 类 号：R614.4[医药卫生—麻醉学]