外周神经刺激器定位腰丛-坐骨神经阻滞在血管外科下肢手术中的应用

目的观察外周神经刺激器定位下的腰丛-坐骨神经阻滞应用于血管外科患者下肢手术的效果。方法20例血管外科拟行单侧下肢手术的患者,施行单侧腰丛-坐骨神经阻滞。腰丛阻滞为腰肌间隙入路,坐骨神经阻滞为臀区入路。采用神经刺激器定位技术,刺激器电流频率1 Hz,起始强度1 mA,麻醉总量为1%利多卡因30 mL、0.5%罗哌卡因30 mL。结果20例患者均阻滞完善,麻醉效果满意,术中生命体征平稳,血流动力学稳定。结论神经刺激器定位技术下腰丛-坐骨神经阻滞定位准确,客观指征明显,效果可靠,对患者各系统干扰小,对有严重合并症患者更为适用。

Lumbosacral-sciatic Plexus Nerve Block Directed by Peripheral Stimulator in Cardiovascu-lar Surgery Patients Undergoing Lower-extremity Surgery

Objective To perform lumbosacral-sciatic plexus nerve block under peripheral stimulator in patients with cardiovascular surgery diseases undergoing lower-extremity surgery.Methods Twenty patients undergoing lower-extremity cardiovascular surgery,were subjected to one-side lumbosacral-sciatic plexus nerve block directed by a peripheral nerve stimulator.Depending on the different opertative site and passive poster,two approaches(psoas compartment approach,transgluteal approach) were chosen to the branches of lumbar pluxus and to the sciatic nerve.The stimulation frequency was 1 Hz,and the stimulation currency was 1 mA.The total dose of local anesthetic was 30 mL 0.5 % ropivacaine and 30 mL 1% lidocaine.Results The block effects on 20 patients were satisfactory.Their hemodynamics was stable.Conclusion By means of a nerve stimulator,lumbosacral-sciatic plexus nerve block is a good choice for lower-extremity anesthesia,especial to old critical-cardiovascular patients.