王爱忠．超声引导下连续股神经阻滞在全膝关节置换术术后镇痛中的 .docVIP

问题1：股神经-坐骨神经联合阻滞可达到良好的阻滞效果。超声引导更可提高阻滞成功率。 回答：谢谢，已 问题2：连续硬膜外麻醉是临床经典麻醉方法，但其可带来尿潴留、马尾损伤等并发症。 回答：谢谢，已，见 问题3：股神经-坐骨神经联合阻滞有利于术后早期活动，利于患者快速康复。 回答：谢谢，已，见 问题4： 请加引本刊文献1条。 回答：谢谢，已添加 超声引导下股神经-坐骨神经联合阻滞麻醉与连续硬膜外麻醉用于胫腓骨骨折手术麻醉效果的比较 姚滢，蒋平2，岑奕1，夏建华1* 摘要：目的：为评估超声引导下股神经-坐骨神经联合阻滞麻醉在胫腓骨骨折手术中的麻醉效果提供临床依据和参考。方法：对90例胫腓骨骨折切开复位内固定手术患者随机分为3组：A组行超声引导下坐骨结节水平股神经-坐骨神经联合阻滞麻醉，B组行超声引导下腘窝处股神经-坐骨神经联合阻滞麻醉，C组行连续硬膜外麻醉；监测3组患者术中HR、BP、SpO2的改变；评估血流动力学改变度、麻醉满意度、镇痛时间、及术后下肢运动恢复度等指标。应用Mann-Whitney U检验比较3组患者间上述指标的差异。结果： Mann-Whitney U检验及t检验结果表明，与C组相比，A组的麻醉满意度、镇痛时间、术后下肢运动恢复度均有显著差异（all P0.01)。与C组相比，B组的血流动力学改变度、镇痛时间、术后下肢运动恢复度均有显著差异（all P0.01)。与B组相比，A组仅麻醉满意度有显著性差异（P0.01）。结论：在超声引导下实施股神经-坐骨神经联合阻滞麻醉能有效减少麻醉后遗症和并发症的发生，且该方法不会造成神经干损害。腘窝处行股神经-坐骨神经联合阻滞麻醉的麻醉方法对膝部及以下各类手术麻醉效果最优。 关键词：超声引导；坐骨神经阻滞；胫腓骨骨折手术；麻醉满意度；镇痛时间；术后下肢运动恢复度 Comparison of Different Sciatic Nerve Block Combined with Femoral Nerve Block Guided by Ultrasound?and Continuous Epidural Anesthesia in Internal Fixation of Tibiofibula Fracture Yao Ying1, Jiang Ping2, Cen Yi1, Xia Jianhua1* 1Department of Anesthesia Management, 411 Hospital,Hongkou District, Shanghai, China 200081 2 Department of Biochemistry?and Psychopharmacology, Shanghai Mental Health Center, Xuhui District, Shanghai, China 200030 *Corresponding Author: Director of Department of Anesthesia Management, Associate chief physician,Tel:021E-mail: jianhuaxia2000@ Abstract:Objective: This investigation provides clinical basis and reference datas for application of sciatic nerve block combined with femoral nerve block under the guidance of ultrasound.?Methods: 90 patients were initially selected for the investigation with tibiofibula fracture open reduction and internal fixation operation and divided into 3 groups. Patients in Group A did an anesthesia?of sciatic nerve combined with femoral nerve block under the guidance of ultrasound; in Group B did an anesthesia?of popliteal fossa sciatic nerve and femoral nerve block under the guidance of ultrasound;in Group C did the continuous epidural block. By m