| 廖华山,姚 喆,霍红艳,何 平,童 华.腰丛-坐骨神经阻滞与腰硬联合麻醉用于老年患者下肢手术中的效果比较[J].,2017,17(32):6328-6331 |
| 腰丛-坐骨神经阻滞与腰硬联合麻醉用于老年患者下肢手术中的效果比较 |
| A Comparison of the Anesthesia Effect of Combined Spinal Epidural Anesthesia and Lumbar Plexus-Sciatic Nerve Blocks on the Patients with Lower Limb Orthopedic Surgery |
| 投稿时间：2017-05-05 修订日期：2017-05-23 |
| DOI：10.13241/j.cnki.pmb.2017.32.028 |
| 中文关键词: 腰丛-坐骨神经阻滞 腰硬联合麻醉 下肢骨折 老年患者 |
| 英文关键词: CSEA LPSB Lower limb fracture Elderly patients |
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| 中文摘要: |
| 摘要 目的：分析和比较两种不同麻醉方式(腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉)对老年患者下肢骨折手术中的效果。方法：以我院收治的下肢骨折拟行手术治疗的老年患者158例作为研究对象，将其随机分为腰硬联合麻醉组(CSEA)和腰丛-坐骨神经阻滞组(LPSB)，每组各79例。CSEA组采用腰硬联合麻醉，LPSB组采用腰丛-坐骨神经阻滞，比较两组患者感觉阻滞起效时间、运动阻滞起效时间、运动恢复时间、维持时间、疼痛感觉评分和并发症的发生状况。结果：CSEA组和LPSB分别有1例和3例患者因局部麻醉失效而需全身麻醉；LPSB组的感觉阻滞起效时间、运动阻滞起效时间、运动恢复时间均显著晚于CSEA组，但其维持时间显著长于CSEA组，患者疼痛感觉评分低于CSEA组(P＜0.05)。结论：与腰硬联合麻醉相比，腰丛-坐骨神经阻滞能为老年下肢骨折手术患者提供有效的单侧麻醉，且安全性高，可作为下肢骨科手术患者的首选麻醉方案。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the analgesic effect of combined spinal epidural anesthesia (CSEA) and lumbar plexus-sciatic nerve blocks (LPSB) on the elderly patients with lower limb orthopedic surgery. Methods: 158 cases of elderly patients with surgical treatment of lower limb fracture in our hospital were chosen. The patients were randomly divided into two groups(combined spinal epidural anesthesia was performed in the combined spinal epidural anesthesia (CSEA) group and the lumbar plexus and sciatic nerves were blocked in the lumbar plexus-sciatic nerve blocks (LPSB) group. The onset of sensory-motor block, success in providing adequate anesthesia, hemodynamic changes, first analgesic request time and VAS socrewere recorded. Results: One patient in the CSEA group and three patients in the LPSB group required general anesthesia due to failed block of each patient were observed. There was no significant differences in the success of providing adequate anesthesia between two groups. The onset of sensory-motor block and the first analgesic request time were significantly later in the LPSB group than CSEA group. However, the duration of analgesia in the LPSB group were longer than CSEA group, the VAS score in LPSB group was significantly lower than CSEA group. Conclusion: The lumbar plexus-sciatic nerve blocks could provide effective unilateral anesthesia and offer a beneficial alternative to combined spinal epidural anesthesia in patients undergoing lower limb orthopedic surgery. |
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