不同浓度罗哌卡因腰丛坐骨神经联合阻滞在下肢手术中的应用

发布时间：2018-04-16 04:36

本文选题：罗哌卡因 + 坐骨神经　；参考：《山东医药》2015年11期

【摘要】：目的观察不同浓度罗哌卡因腰丛坐骨神经联合阻滞在下肢手术中的应用效果。方法择期接受膝及膝关节以下手术患者60例,随机分为0.3%罗哌卡因神经阻滞麻醉组(L组)和0.4%罗哌卡因神经阻滞麻醉组(H组),每组30例。两组均采用神经刺激仪定位进行腰丛坐骨神经联合阻滞,L组给予0.3%罗哌卡因24 m L坐骨神经阻滞与20 m L腰丛神经阻滞。H组给予0.4%罗哌卡因20 m L坐骨神经阻滞与13 m L腰丛神经阻滞。观察并比较两组腓浅神经、腓肠神经外侧皮支、胫神经根内侧支阻滞起效时间及起效时间20 min的例数、麻醉效果。结果L组腓浅神经、腓肠神经外侧皮支、胫神经根内侧支阻滞起效时间分别为(8.9±4.5)、(8.2±4.0)、(7.9±5.1)min;H组分别为(9.1±5.1)、(8.3±3.2)、(8.2±4.2)min,两组比较,P均0.05。L、H组患者起效时间超过20min的患者分别为3、2例,两组比较,P0.05;麻醉效果良好患者分别为30、24例,两组比较,P0.05。结论相同剂量时,0.3%较0.4%罗哌卡因腰丛坐骨神经联合阻滞在下肢手术中麻醉效果好。
[Abstract]:Objective to observe the effect of combined lumbar plexus sciatic nerve block with ropivacaine at different concentrations in lower limb surgery.Methods 60 patients with knee and knee joint were randomly divided into 0. 3% ropivacaine nerve block group (L group) and 0. 4% ropivacaine nerve block anesthesia group (30 cases in each group).Both groups were given 0. 3% ropivacaine 24 mL sciatic nerve block and 20 mL lumbar plexus nerve block. H group was given 0.4% ropivacaine 20 mL sciatic nerve block.And 13 mL lumbar plexus nerve block.To observe and compare the onset time and onset time of the superficial peroneal nerve, the lateral cutaneous branch of sural nerve and the medial branch of tibial nerve root for 20 min, and the anesthetic effect.Results the onset time of superficial peroneal nerve, lateral cutaneous branch of sural nerve and medial branch of tibial nerve root in group L was 8.9 卤4.5 tibial nerve root branch and 7.9 卤5.1 minutes in group H, respectively, compared with 8.3 卤3.2 minutes in group H and 8.2 卤4.2 minutes in group H. The onset time of patients in both groups was higher than that in 20min group (n = 2).There were 24 patients with good anaesthesia and 24 patients with good anaesthesia, compared with P0.05in the two groups.Conclusion combined lumbar plexus sciatic nerve block with 0.3% ropivacaine at the same dose is effective in lower limb surgery.
【作者单位】：中国人民解放军海军总医院;
【分类号】：R614.3

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