超声引导腰丛-坐骨神经阻滞与单侧腰麻在老年患者单侧下肢手术中的疗效对比
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摘要
目的比较超声引导下腰丛-坐骨神经阻滞与单侧腰麻在老年患者单侧下肢手术中的疗效。方法老年患者单侧下肢手术患者80例,随机分为超声引导腰丛-坐骨神经阻滞组(A组)和单侧腰麻组(0.75%布比卡因2 m L+10%葡萄糖1 m L混合,B组),观察2组患者麻醉效果、血流动力学变化。结果 B组在麻醉操作时间、麻醉起效时间和麻醉维持时间明显短于A组,B组对血流动力学的影响明显大于A组。结论超声引导腰丛-坐骨神经阻滞与单侧腰麻均适合老年患者下肢手术的麻醉,在对患者血流动力学影响、麻醉作用时间、并发症方面,超声引导腰丛-坐骨神经阻滞更具优势。
Objective To compare the efficacy of the ultrasound guided lumbar plexus sciatic nerve block with the unilateral lumbar anesthesia in unilateral lower limb surgery for elderly patients. Methods A total of 80 elderly patients undergoing unilateral lower limb surgery were randomly divided into ultrasound guided lumbar plexus sciatic nerve block group(group A) and unilateral spinal anesthesia group(0.75% bupivacaine 2 mL+10% glucose 1 mL mixture group, B group). The anesthetic effect and hemodynamic changes of 2 groups were observed. Results The time of anesthesia operation, anesthesia onset time and anesthesia maintenance time were significantly shorter in group B than in group A, and the change of Mean Artery Pressure(MAP)and Heart Rate(HR)was significantly greater in group B than that in group A. Conclusion Ultrasound guided lumbar plexus sciatic nerve block and unilateral spinal anesthesia are suitable for anesthesia in elderly patients undergoing lower limb surgery. The ultrasound guided lumbar plexus sciatic nerve block has more advantages than the unilateral spinal anesthesia in terms of hemodynamic effects, anesthetic time and complications.
Objective To compare the efficacy of the ultrasound guided lumbar plexus sciatic nerve block with the unilateral lumbar anesthesia in unilateral lower limb surgery for elderly patients. Methods A total of 80 elderly patients undergoing unilateral lower limb surgery were randomly divided into ultrasound guided lumbar plexus sciatic nerve block group(group A) and unilateral spinal anesthesia group(0.75% bupivacaine 2 mL+10% glucose 1 mL mixture group, B group). The anesthetic effect and hemodynamic changes of 2 groups were observed. Results The time of anesthesia operation, anesthesia onset time and anesthesia maintenance time were significantly shorter in group B than in group A, and the change of Mean Artery Pressure(MAP)and Heart Rate(HR)was significantly greater in group B than that in group A. Conclusion Ultrasound guided lumbar plexus sciatic nerve block and unilateral spinal anesthesia are suitable for anesthesia in elderly patients undergoing lower limb surgery. The ultrasound guided lumbar plexus sciatic nerve block has more advantages than the unilateral spinal anesthesia in terms of hemodynamic effects, anesthetic time and complications.
引文
[1]赖建鸿,龙燕.重比重布比卡因单侧腰麻在高龄患者单侧下肢手术中的疗效[J].中国临床药理学杂志,2013,29(4):252—253.
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[4]Karmakar MK,Ho AM,Li X,et al.Ultrasound-guided lum-bar plexus block through the acoustic window of the lumbar ultrasound trident[J].Br J Anaesth,2008,100:533-537.
[5]周子戎,汪春英.腰-硬联合麻醉在80岁以上高危老年病人骨科手术的应用[J].临床麻醉学杂志,2008,24:40-41.
[6]Capdevila X,Biboulet P,Morau D,et al.Howand why to use ultrasound for regional blockade[J].Acta Anaesthesiol Belg,2008,59:147-154.
[7]Abrahams MS,Aziz MF,Fu RF,et al.Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block:a systematic reviewand meta-analysis of randomized controlled trials[J].Br J Anaesth,2009,102:408-417.
[8]van Geffen GJ,van den BE,Braak GJ,et al.A prospective randomised controlled trial of ultrasound guided versus nerve stimulation guided distal sciatic nerve block at the popliteal fossa[J].Anaesth Intensive Care,2009,37:32-37.
[9]于澎,王朝霞,代里根,等.超声引导联合神经刺激仪辅助下肢神经阻滞用于老年患者全膝关节置换术的临床研究[J].新疆医学,2017,47(1):44-47.
[10]李挺,金勉,徐旭仲,等.腰丛-坐骨神经阻滞应用于老年病人下肢手术[J].温州医学院学报,2005,35(5):376-378.
[2]吴强,江伟.经皮电刺激引导在下肢神经阻滞中的应用[J].临床麻醉学杂志,2009,25:474-476.
[3]Kirchmair L,Entner T,Kapral S,et al.Ultrasound guidance for the psoas compartment block:an imaging study[J].Anesth Analg,2002,94:706-710.
[4]Karmakar MK,Ho AM,Li X,et al.Ultrasound-guided lum-bar plexus block through the acoustic window of the lumbar ultrasound trident[J].Br J Anaesth,2008,100:533-537.
[5]周子戎,汪春英.腰-硬联合麻醉在80岁以上高危老年病人骨科手术的应用[J].临床麻醉学杂志,2008,24:40-41.
[6]Capdevila X,Biboulet P,Morau D,et al.Howand why to use ultrasound for regional blockade[J].Acta Anaesthesiol Belg,2008,59:147-154.
[7]Abrahams MS,Aziz MF,Fu RF,et al.Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block:a systematic reviewand meta-analysis of randomized controlled trials[J].Br J Anaesth,2009,102:408-417.
[8]van Geffen GJ,van den BE,Braak GJ,et al.A prospective randomised controlled trial of ultrasound guided versus nerve stimulation guided distal sciatic nerve block at the popliteal fossa[J].Anaesth Intensive Care,2009,37:32-37.
[9]于澎,王朝霞,代里根,等.超声引导联合神经刺激仪辅助下肢神经阻滞用于老年患者全膝关节置换术的临床研究[J].新疆医学,2017,47(1):44-47.
[10]李挺,金勉,徐旭仲,等.腰丛-坐骨神经阻滞应用于老年病人下肢手术[J].温州医学院学报,2005,35(5):376-378.