超声引导神经阻滞辅以瑞芬太尼用于膝部以下手术麻醉的观察

摘要

Objective To observe the anesthesia efficacy of single sciatic nerve block or combined femoral nerve block guided with ultrasound supplemented with intravenous remifentanil in patients undergoing lower limb surgeries below knee. Methods Forty patients undergoing selective lower limb surgeries below knee were randomly assigned to single sciatic nerve block group (group SB) and combined femoral nerve block group (group FSB) with 20 cases each, and a continuous intravenous infusion of remifentanil was given to all patients. Following variables were recorded: procedure time of nerve block, visual analog scale (VAS) of pain, infusion rate of remifentanil, satisfaction scoring and adverse reaction. Results Compared with group SB, patients in group FSB had lower VAS pain scores, slower infusion rate of remifentanil, fewer adverse reactions, and higher satisfaction ( P < 0. 05 or P < 0. 01). Conclusion Combined femoral nerve block guided with ultrasound supplemented with less 0.1 μg·kg1·min-1 of remifentanil is an effective and safety anesthetic means in patients undergoing lower limb surgeries below knee.%目的 观察超声引导下单纯腘窝坐骨神经阻滞或联合股神经阻滞辅以瑞芬太尼用于膝部以下手术的麻醉效果.方法 拟行膝部以下手术患者40例,随机均分为腘窝坐骨神经阻滞联合股神经阻滞组(FSB组)与单纯腘窝坐骨神经阻滞组(SB组),所有患者均静脉连续输注瑞芬太尼.记录神经阻滞操作时间、术中VAS疼痛评分、瑞芬太尼输注速率、患者满意度及不良反应.结果 与SB组比较,FSB组VAS疼痛评分明显降低,瑞芬太尼输注速率减慢,患者满意度明显升高,药物相关并发症发生率明显降低(P＜0.05或P＜0.01).结论 联合股神经阻滞辅以低于0.1μg·kg-1·min-1瑞芬太尼可安全有效地用于膝部以下手术麻醉.