股神经联合坐骨神经阻滞应用在踝关节镜手术中的效果评价

目的 比较两种不同的麻醉方式在踝关节镜手术中的应用效果。方法 选择2018年1月至2019年12月在中山大学孙逸仙纪念医院行踝关节镜手术的患者60例,随机分为股神经组和腰丛组,每组各30例,股神经组实施股神经联合坐骨神经阻滞,腰丛组实施腰丛联合坐骨神经阻滞。比较两组患者术中和术后的麻醉和镇痛效果、麻醉操作时间、不同时间的心率及平均血压和麻醉并发症及不良反应。结果 两组患者术中额外使用局麻药和麻醉性镇痛药人数、术后24小时内静息或运动的VAS评分及额外使用镇痛药的人数和使用时间差异均无统计学意义;股神经组麻醉操作时间显著少于腰丛组;股神经组在麻醉操作过程中的心率和平均血压显著低于腰丛组;两组患者术后不良反应比较差异无统计学意义。结论 股神经联合坐骨神经阻滞与腰丛联合坐骨神经阻滞在踝关节镜手术中的麻醉和术后镇痛效果无显著差别,但前者麻醉操作时间更短,围术期生命体征更平稳。

Application of combination femoral nerve with sciatic nerve block in patients undergoing ankle arthroscopic surgery

Objective To compare the effects of two different anesthesia methods in patients undergoing ankle arthroscopic surgery. Methods Sixty adult patients undergoing ankle arthroscopic surgery in Sun Yat-sen Memorial Hospital from January 2018 to December 2019 were randomly divided into femoral nerve group and lumbar plexus group, with 30 cases in each group. The femoral nerve group received combination of femoral nerve with sciatic nerve block, and the lumbar plexus group received combination of lumbar plexus with sciatic nerve block. The effects of anesthesia and analgesia, the operation time of anesthesia, heart rate and mean blood pressure at different times, complications and adverse reactions of anesthesia were compared between the two groups. Results There were no statistically significant differences between the two groups in the number of patients who used supplementary local anesthetics and anesthetic analgesic drugs during the operation, VAS score at rest or with movement and the number patients who used additional analgesics within 24 hours after the operation. The anesthetic operation time of femoral nerve group was significantly less than that of lumbar plexus group. The heart rate and mean blood pressure of femoral nerve group during anesthetic operation were significantly lower than that of lumbar plexus group. The side effects showed no significant differences between groups. Conclusion There were no significant difference in anesthesia and postoperative analgesia effect between combination femoral nerve with sciatic nerve block and combination lumbar plexus with sciatic nerve block during ankle arthroscopic surgery, however, the former had shorter anesthetic operation time and more stable perioperative vital signs.