PNS定位腰丛-坐骨神经联合阻滞应用于下肢骨科手术的可行性分析

目的：探讨神经刺激器（PNS）定位腰丛-坐骨神经联合阻滞在下肢骨科手术中的麻醉效果。方法：将2010年6月至2011年12月在本院行下肢骨科手术的70例患者随机分成两组：实验组35例，患者采用PNS定位腰丛-坐骨神经联合阻滞麻醉；对照组35例，患者采用硬膜外麻醉。观察比较两组患者的手术麻醉相关时间参数、术中输液量、术后VAS评分、不良反应发生情况和血流动力学变化情况。结果：实验组的感觉和运动神经阻滞起效时间明显短于对照组（P〈0．05）；实验组的感觉和运动神经阻滞维持时间明显长于对照组（P〈0．05）；实验组的术中输液量明显少于对照组（P〈0．05）；实验组的术后VAS评分明显优于对照组（P〈0．05）；实验组的不良反应发生率明显低于对照组（P〈0．05）；实验组患者T1、T2、1r3、T4、B时段的SBP、DBP指标值均比对照组稳定（P〈0．05）。结论：PNS定位腰丛-坐骨神经联合阻滞应用于下肢骨科手术的麻醉效果良好。

The Analysis of Lumbar Plexus-sciatic Nerve Block in Lower Limb Orthopedic Surgical of Patients by Peripheral Nerve Stimulator

Objective： To investigate the clinical effect of lumbar plexus-sciatic nerve block by periph- eral nerve stimulator for patients lower limb orthopedic surgical. Method： The 70 cases of patients admitted to hospital from June 2010 to December 2011 were randomly divided into two groups, treatment group （n = 35 ） and control group （n=35）. The control group was given epidural anesthesia; but the treatment group was given lumbar plexus-sciatic nerve block by peripheral nerve stimulator anesthesia. The anesthesia time parameters, the intraoperative infusion volume, the postoperative VAS score, the incidence of adverse reactions, and the changes of hemodynamic in 2 groups was observed and compared. Result： The onset time of sensory and motor nerve block in the treatment group were significantly shorter than the control group （ P〈0. 05 ） ; the maintenance time of sensory and motor nerve block in the treatment group were significantly longer than the control group （ P〈0.05 ） ; the intraoperative inffusion volume and the incidence of adverse reactions in the treatment group was significantly less than the control group （P〈0.05） ; the postoperative VAS score in the treatment group was significantly better than the control group （ P〈0.05 ） ; the index value of SBP and DBP in T1 ,T2, T3 ,T4 ,T5 in the treatment group was significantly steady than the control group （P〈0.05）. Conclusion： There is a significant clinical effect of lumbar plexus-sciatic nerve block by peripheral nerve stimulator for patients＇lower limb orthopedic surgical.