神经刺激器定位下采用罗哌卡因行腰丛联合坐骨神经阻滞对膝关节镜手术患者的影响分析(1)
【摘要】 目的：探究和分析神经刺激器定位下采用罗哌卡因行腰丛联合坐骨神经阻滞对膝关节镜手术患者的影响。方法：选取700例本院行膝关节镜手术的患者，采用随机数字表法分为A、B两组，每组各350例。A组在神经刺激器定位下行腰丛联合坐骨神经阻滞麻醉，B组采取腰硬联合阻滞麻醉，记录并比较患者术中生理功能、麻醉维持时间、术后感觉恢复时间、运动恢复时间以及术后首次排尿时间。结果：两组患者术中生理指标比较，A组患者的MAP、HR低于B组，两组比较差异有统计学意义(P<0.05)；A组患者的麻醉起效时间、术后感觉恢复时间、运动恢复时间、术后首次排尿时间分别为(5.2±1.0)min、(3.7±1.3)h、(4.8±1.4)h、(3.2±0.2)h均短于B组的(14.8±1.3)min、(4.8±1.5)h、(5.3±1.8)h、(4.5±0.5)h，两组比较差异均有统计学意义(P<0.05)。结论：对膝关节镜手术患者在神经刺激器定位下采用罗哌卡因行腰丛联合坐骨神经阻滞的麻醉方法安全性高，术后恢复好，麻醉效果显著。
【关键词】 神经刺激器； 膝关节镜手术； 腰丛联合坐骨神经阻滞
, 百拇医药
【Abstract】 Objective： To explore and analyze the influence of combined lumbar plexus and sciatic nerve block by use of ropivacaine under nerve stimulator on patients with knee arthroscope operation.Method： 700 patients with knee arthroscopic operation were selected in our hospital， they were randomly divided into group A and B，350 cases in each group. Group A was treated with combined lumbar plexus and sciatic nerve block under nerve stimulator，group B was took combined spinal and epidural anesthesia，patients’ physiological function， maintenance of anesthesia time and postoperative sensory recovery time， motor recovery time and postoperative first micturition time were recorded and compared.Result：Compared the physiological index of two groups，the MAP and HR of group A were lower than the group B，the differences were statistically significant(P<0.05).Anesthesia work time， postoperative sensory recovery time， sports recovery time and the first urine time of group A was respectively (5.2±1.0)min，(3.7±1.3)h，(4.8±1.4)h，(3.2±0.2)h， shorter than (14.8±1.3)min，(4.8±1.5)h，(5.3±1.8)h，(4.5±0.5) of group B，the differences were statistically significant(P<0.05).Conclusion： Patients with knee arthroscope operation use of ropivacaine under nerve stimulator combined lumbar plexus and sciatic nerve block has high safety and good postoperative recovery， its anesthesia effect is remarkable.
, 百拇医药
【Key words】 Nerve stimulator； Knee arthroscopic operation； Combined lumbar plexus and sciatic nerve block
First-author’s address：The NO.4 People’s Hospital of Hengshui，Hengshui 053000，China
doi：10.3969/j.issn.1674-4985.2015.25.003
膝关节镜手术的传统麻醉方法采用腰硬联合阻滞，随着神经刺激定位仪的问世，在神经定位仪下行腰丛联合坐骨神经阻滞的方法，由于其操作方便，对患者生理功能影响轻微，在临床实践中得到普遍应用[1]。罗哌卡因因其长效性和不良反应少，麻醉禁忌证及并发症相对较少等优点，对老年患有心血管疾患或低血容量的患者更为适合。因此，对维持循环稳定具有重要的意义，已经成为用于神经阻滞的常用局麻药[2]。由于罗哌卡因为长效酰胺类局麻药，对心脏和神经毒性均较低，所以常被用于周围神经阻滞。罗哌卡因复合阿片类药物有神经阻滞的效果，但各种研究报道的说法还不统一。此次研究旨在观察和分析神经刺激定位下采用罗哌卡因行腰丛联合坐骨神经阻滞对膝关节镜手术患者的影响，并与传统的麻醉方法腰硬联合阻滞作对比，现报告如下。, 百拇医药(陈庆国)
【关键词】 神经刺激器； 膝关节镜手术； 腰丛联合坐骨神经阻滞
, 百拇医药
【Abstract】 Objective： To explore and analyze the influence of combined lumbar plexus and sciatic nerve block by use of ropivacaine under nerve stimulator on patients with knee arthroscope operation.Method： 700 patients with knee arthroscopic operation were selected in our hospital， they were randomly divided into group A and B，350 cases in each group. Group A was treated with combined lumbar plexus and sciatic nerve block under nerve stimulator，group B was took combined spinal and epidural anesthesia，patients’ physiological function， maintenance of anesthesia time and postoperative sensory recovery time， motor recovery time and postoperative first micturition time were recorded and compared.Result：Compared the physiological index of two groups，the MAP and HR of group A were lower than the group B，the differences were statistically significant(P<0.05).Anesthesia work time， postoperative sensory recovery time， sports recovery time and the first urine time of group A was respectively (5.2±1.0)min，(3.7±1.3)h，(4.8±1.4)h，(3.2±0.2)h， shorter than (14.8±1.3)min，(4.8±1.5)h，(5.3±1.8)h，(4.5±0.5) of group B，the differences were statistically significant(P<0.05).Conclusion： Patients with knee arthroscope operation use of ropivacaine under nerve stimulator combined lumbar plexus and sciatic nerve block has high safety and good postoperative recovery， its anesthesia effect is remarkable.
, 百拇医药
【Key words】 Nerve stimulator； Knee arthroscopic operation； Combined lumbar plexus and sciatic nerve block
First-author’s address：The NO.4 People’s Hospital of Hengshui，Hengshui 053000，China
doi：10.3969/j.issn.1674-4985.2015.25.003
膝关节镜手术的传统麻醉方法采用腰硬联合阻滞，随着神经刺激定位仪的问世，在神经定位仪下行腰丛联合坐骨神经阻滞的方法，由于其操作方便，对患者生理功能影响轻微，在临床实践中得到普遍应用[1]。罗哌卡因因其长效性和不良反应少，麻醉禁忌证及并发症相对较少等优点，对老年患有心血管疾患或低血容量的患者更为适合。因此，对维持循环稳定具有重要的意义，已经成为用于神经阻滞的常用局麻药[2]。由于罗哌卡因为长效酰胺类局麻药，对心脏和神经毒性均较低，所以常被用于周围神经阻滞。罗哌卡因复合阿片类药物有神经阻滞的效果，但各种研究报道的说法还不统一。此次研究旨在观察和分析神经刺激定位下采用罗哌卡因行腰丛联合坐骨神经阻滞对膝关节镜手术患者的影响，并与传统的麻醉方法腰硬联合阻滞作对比，现报告如下。, 百拇医药(陈庆国)