摘要
目的探讨超声引导下以旋髂深动脉为标记的髂腹股沟-髂腹下神经阻滞在老年斜疝手术中的临床应用效果。方法选择择期行斜疝手术的老年患者40例,男33例,女7例,年龄65~90岁,ASAⅠ~Ⅲ级,随机分为两组,每组20例。T组采用传统髂腹股沟-髂腹下神经阻滞解剖定位方法;V组采用超声引导下以旋髂深动脉为标记的髂腹股沟-髂腹下神经阻滞。记录神经阻滞起效时间,术中、术后6h VAS评分,麻醉满意度以及尿潴留、误入血管等并发症的发生情况。结果 V组神经阻滞起效时间明显短于T组[(6.1±1.8)min vs(12.1±2.0)min,P<0.05];T组术中VAS评分明显高于V组[(4.5±1.1)分vs(2.1±0.9)分,P<0.05]。术后6h两组VAS评分差异无统计学意义;V组麻醉满意度明显高于T组(P<0.05)。两组均未出现尿潴留,T组有1例误入血管。结论超声引导下以旋髂深动脉为标记的髂腹股沟-髂腹下神经阻滞能为老年斜疝手术患者提供安全、有效、可靠的麻醉。
Objective To explore the clinical effect of ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profunda in elderly hernia surgery.Methods Forty ASA Ⅰ-Ⅲ grade patients（33 males and 7 females）of 65-90 years old scheduled for elective hernia surgery were randomly divided into two groups（n=20）.In group T,patients received ilioinguinal/iliohypogastric nerve blocks bytraditional anatomical positioning;in group V,patients received ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profunda.The comparison was made between the two groups in term of onset time of anesthesia,VAS score of intraoperative and postoperative 6 h.Anesthesia satisfaction,incidence of uroschesis,misplacement local anesthetics into blood-vessels were recorded.Results The onset time of anesthesia in group V was significantly shorter than that in group T [（6.1±1.8）min vs（12.1±2.0）min,P〈0.05].The VAS score of intraoperative in group T was significantly higher than that of group V [（4.5±1.1）scores vs（2.1±0.9）scores,P 〈0.05].The anesthesia satisfaction of group V was higher than that of group T（P〈0.05）.There was one misplacement local anesthetics into blood-vessels in group T.Conclusion Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profunda can provide safe,effective and reliable anesthesia in elderly hernia surgery.
作者
濮健峰
王梅芳
潘四磊
沈志强
冯婉琳
PU Jianfeng WANG Meifang PAN Silei SHEN Zhiqiang FENG Wanlin.(Department of Anesthesiology, the Fifth Clinical Medical College of Yangzhou University, Changshu 215500, China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2017年第10期974-976,共3页
Journal of Clinical Anesthesiology
基金
常熟市卫计委资助性重点项目(csws201501)
关键词
超声
旋髂深动脉
神经阻滞
老年
疝气
Ultrasound
Arteriae circumflexa ilium profunda
Nerve block
Elderly
Hernia
