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| 超声引导前路坐骨神经阻滞多点与单点注射的比较 |
| Comparison of multiple injection and single injection techniques ultrasound guided anterior sciatic nerve block |
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| DOI： |
| 中文关键词: 超声引导 前路 坐骨神经阻滞 |
| 英文关键词: Ultrasound-guided Anterior Sciatic nerve block |
| 基金项目:陕西省社会发展科技攻关项目（2016SF-111） |
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| 中文摘要: |
| 目的 比较超声引导前路坐骨神经阻滞多点注射与单点注射技术的差异。方法 选择行足踝部手术患者90例,男47例,女43例,年龄18～68岁,ASA Ⅰ～Ⅲ级,随机分为多点注射组(M组)和单点注射组(S组),每组45例。超声引导行前路坐骨神经阻滞,分别给予0.5%盐酸罗哌卡因20 ml。记录两组坐骨神经宽度、厚度、深度及阻滞操作时间;注射局麻药后10、20和30 min时运动阻滞及腓浅神经、腓肠神经、腓深神经、胫神经感觉阻滞情况;麻醉相关并发症的发生情况。结果 超声图像上两组坐骨神经宽度、厚度、深度差异无统计意义。M组阻滞操作时间明显长于S组(P＜0.05),腓浅神经在注药后10、20和30 min、腓肠神经在注药后20和30 min、胫神经在注药后30 min的感觉阻滞完善率M组明显高于S组(P＜0.05),注药后30 min时M组足跖屈、背伸运动阻滞完善率明显高于S组(P＜0.05),两组术后恶心呕吐、耳鸣等不良反应差异无统计学意义。结论 超声引导经前路坐骨神经阻滞多点注射局麻药较单点注射需要更多操作时间,但感觉、运动阻滞起效快,两组术后恶心呕吐、耳鸣等不良反应差异无统计学意义。 |
| 英文摘要: |
| Objective To compare the difference of ultrasound-guided anterior sciatic nerve block by multiple injection and single injection. Methods Among 90 patients undergoing lower limb operation, aged 18-68 years old, 47 patients were males and 43 patients were females, all falling into ASA Ⅰ-Ⅲ. The patients were randomized to ultrasound guided anterior sciatic nerve block by multiple injection (group M, n=45) single injection (group S, n=45). Local anesthetic of 0.5% ropivacaine hydrochloride 20 ml was used. The width, thickness and depth of sciatic nerve and blocking performance time were recorded. Sensory and motor blockade on the operated limb were evaluated every 10 minutes after injection of local anesthetic for 30 minutes and complications were observed in two groups. Results The width, thinkness and depth of sciatic nerve on the ultrasound screen were not statistically significant in the two groups. The performance time of group M was longer than that of group S (P＜0.05). The proportion of patients with sensory blockade of each nerve significantly differed between the two groups: for superficial peroneal nerve at 10, 20, and 30 minutes, for the sural nerve at 20, 30 minutes, for the tibial nerve at 30 minutes, that of group M was higher than that of group S (P＜0.05). A significantly greater rate of motor blockade was observed for the dorsal flexion of foot and toes extension in group M than that of group S at 30 minutes (P＜0.05). The complications of nausea, vomitting and tinnitus were not different in two groups. Conclusion Multiple injection needs more operation time compared with single injection, but its onset time of sensory and motor blockade is quicker, the complications were not different. |
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