超声引导下腰丛-坐骨神经阻滞与连续硬膜外麻醉在膝关节手术中的应用

目的分析超声引导下腰丛-坐骨神经阻滞与连续硬膜外麻醉在膝关节手术中的应用效果差异。方法选择在本院接受膝关节手术的246例患者作为研究对象,按照随机数表法分为接受超声引导下腰丛-坐骨神经阻滞的观察组患者与接受连续硬膜外麻醉的对照组患者各123例,观察患者麻醉后感觉与运动阻滞的起效时间、维持时间,麻醉前后的血流动力学指标以及麻醉后不良反应发生率等情况。结果①麻醉穿刺给药完成后,观察组患者的感觉阻滞与运动阻滞的起效时间明显短于对照组患者、维持时间明显长于对照组患者（P〈0.05）;②麻醉完成后10,30,60min二组患者的HR、SBP、DBP均有不同程度降低（P〈0.05）,且观察组患者的HR、SBP、DBP水平明显低于对照组患者（P〈0.05）;③麻醉结束后,观察组患者的不良反应发生率明显低于对照组患者（P〈0.05）。结论超声引导下腰丛-坐骨神经阻滞可以有效优化膝关节手术患者的麻醉起效及维持时间,降低血压、心率等血流动力学指标值,同时减少麻醉不良反应发生,是一种高效安全的麻醉方式。

APPLICATION OF ULTRASOUND-GUIDED LUMBAR PLEXUS-SCIATIC NERVE BLOCKING AND CONTINUOUS EPIDURAL ANESTHESIA IN KNEE SURGERY

Objective To analyze the effect of Ultrasound-guided lumbar plexus-sciatic nerve blocking and continuous epidural anesthesia in knee surgery.Methods A sample of 246 cases was chosen, who were treated with knee surgery in author＇s hospital,the subjects were randomly divided into two groups with 123 cases each.The observation group underwent ultrasound guidance lumbar plexussciatic nerve blocking and control group accepted continuous epidural anesthesia,then to observe the sensory after anesthesia and motor block onset time,duration of anesthesia and hemodynamic parameters,incidence of adverse reactions.Results After completion of the administration of anesthesia puncture,the onset time of sensory and motor block in observation group was significantly shorter than that in control group,the duration time was also significantly longer than control group（P〈0.05）;After anesthesia in 10min,30min,60min,the HR,SBP,DBP in two groups both had different degrees of decline（P〈0.05）,and the levels of HR,SBP,DBP in the observation group were significantly lower than the control group（P〈0.05）;After the end of anesthesia,the incidence of adverse reactions in the observation group was significantly lower than the control group（P〈0.05）. Conclusions Ultrasound-guided lumbar plexus-sciatic nerve blocking can effectively optimize anesthesia onset and maintenance time in knee surgery,reduce blood pressure,heart rate and other hemodynamic values,while reducing the incidence of adverse reactions of anesthesia and is a safe and efficient method of anesthesia.