超声引导股神经联合坐骨神经阻滞在下肢手术中的应用

目的探讨超声引导下股神经联合坐骨神经阻滞在下肢手术中镇痛及阻滞效果。方法选择择期单侧下肢手术患者60例，ASAII或Ⅲ级，随机均分为超声引导股神经联合坐骨神经阻滞组（A组）和腰硬联合麻醉组（B组）。A组在超声引导下进行坐骨神经联合股神经阻滞，分别在坐骨神经及股神经周围注射25ml、20ml0．5％罗哌卡因。记录两组感觉、运动神经阻滞起效、完善及持续时间，术后镇痛持续时间，运动阻滞持续时间，视觉模拟疼痛评分（VAS）。结果A组在超声引导下顺利完成股神经联合坐骨神经阻滞；与B组比较，A组术后各时点VAS评分均在3分以下，且术后24h明显低于B组（P〈0．05）；A组感觉阻滞持续时间明显长于B组（P〈0．05），运动阻滞持续时间明显长于B组（P〈0．05）。结论超声引导下行股神经联合坐骨神经阻滞用于下肢手术准确及成功率高，明显增加术后镇痛效果。

Application of ultrasound- guided femoral nerve combined sciatic nerve block in lower limbs surgery

Objective To investigate the effect of ultrasound - guided femoral and sciatic nerve block in the lower limbs surgery. Methods Sixty patients （ ASA Ⅱ orⅢ）, scheduled for elective lower limbs operation, were divided into two groups（ n =30, each） ： sciatic combined femoral nerve block group（ group A） and spinal combined epidural anesthesia group（ group B）. The patients which in group A , received femoral and sciatic nerve injection of 0. 5% ropivacaine under ultrasound - guided. The patients which in group B, received 0. 75% bupivacaine 2. 0ml ＋ 10% glucose l. 0ml in spinal combined epidural anesthesia. Recording two groups, Including sensory,motor nerve block onset,Sound and duration, duration of postoperative analgesia, motor block duration, visual analog pain score （VAS）. Results Femoral and sciatic nerve block were accomplished in group A under the ultrasound - guided. Compared with group B, VAS scores of A group were less than 3 at each time point, and significantly lower than group B（P 〈0. 05） in 24h after surgery ; In group A, du- ration of sensory block was significantly longer than group B （ P 〈 0. 05 ） , duration of motor block was significantly longer than group B （ P 〈 O. 05 ）. Conclusion Application of ultrasound - guided femoral nerve combined sciatic nerve block in the lower limbs surgery, were accurate and high success rate, significantly increased postoperative analgesia.