摘要
目的:比较股神经联合坐骨神经阻滞与腰丛联合坐骨神经阻滞在糖尿病足膝下截肢术中的应用效果。方法:回顾分析2016年12月至2019年12月在我院实施糖尿病足膝下截肢手术的58例患者的病例资料,比较两组患者不同时段的平均血压、心率、术中是否追加局部麻醉药和镇痛药、麻醉操作时间、术后镇痛药物使用情况、有无麻醉并发症、术前及手术结束时的血糖和乳酸水平。结果:58例患者麻醉方式为股神经联合坐骨神经阻滞(股神经组,n=30)和腰丛联合坐骨神经阻滞(腰丛组,n=28)。腰丛组麻醉操作时间显著多于股神经组;腰丛组在麻醉操作时的最高平均血压和最快心率显著高于股神经组;术中追加补救性药物的人数和术后镇痛药物使用情况差异均无统计学意义;术前及手术结束时的血糖和乳酸水平差异比较无统计学意义。结论:股神经阻滞联合坐骨神经阻滞和腰丛阻滞联合坐骨神经阻滞两种麻醉方式对糖尿病足膝下截肢术同样有效,但前者麻醉操作更简单,所需时间短,生命体征更平稳。
Objective:Tocompare the effect of femoral nerve-sciatic nerve block with lumbar plexus-sciatic nerve block in patients undergoing diabetic foot subknee amputation.Methods:The clinical data of 58 patients underwent diabetic foot amputationin Sun Yat-sen Memorial Hospital from December 2016 to December 2019 were reviewed.Heart rate and mean blood pressure at different times,whether to add remedial local anesthetics and analgesics during the operation,the operation time of anesthesia,the use of analgesics after the operation,anesthetic complications or not,and the blood glucose and lactic acid levels before and at the end of the operation were compared between the two groups.Results:The anesthesia methods of 58 patients were femoral nerve combined with sciatic nerve block(femoral nerve group,n=30)and lumbar plexus combined with sciatic nerve block(lumbar plexus group,n=28).The anesthetic operation time of the lumbar plexus group was significantly more than that in femoral nerve group.The maximal mean blood pressure and heart rate in the femoral nerve group during anesthetic operation were significantly lower than those in the lumbar plexus group.There were no statistically significant differences in the number of intraoperative supplementary local anesthetics and analgesics and in the use of postoperative analgesics.There was also no significant difference in blood glucose and lactic acid levels before and at the end of surgery.Conclusion:There was no significant differencein anesthesia and postoperative analgesia effect between combination femoral nerve with sciatic nerve block and combination lumbar plexuswith sciatic nerve blockduring diabetic subknee amputation,however,the former had more stable perioperative hemodynamics,shorter anesthetic operation time and lower complications.
作者
张雪荣
温婧
罗建伟
ZHANG Xue⁃rong;WEN Jing;LUO Jian⁃wei(Department of Anesthesiology,Sun Yat⁃sen Memorial Hospital of Sun Yat⁃sen University,510120)
出处
《岭南急诊医学杂志》
2020年第5期484-486,506,共4页
Lingnan Journal of Emergency Medicine
关键词
股神经联合坐骨神经阻滞
腰丛联合坐骨神经阻滞
糖尿病足
截肢术
combination of femoral nerve with sciatic nerve block
combination of lumbar plexus with sciatic nerve block
diabetic foot
amputation
