CAJ | 학술논문

目的比较单次注射法与双次注射法行坐骨神经阻滞的效果.方法择期行单侧足踝手术患者60例,ASA分级Ⅰ或Ⅱ级,性别不限,年龄18 ～ 64岁,体重48～72 kg,采用随机数字表法,将其分为2组(n=30):单次注射组(S组)和双次注射组(D组).采用Labat-winnie入路在神经刺激仪引导下行坐骨神经阻滞.S组出现背屈或跖屈时,注射0.5％罗哌卡因30 ml;D组出现背屈和跖屈时,各注射0.5％罗哌卡因15 ml.记录定位失败情况.记录操作完成时间、感觉阻滞和运动阻滞起效及维持时间、总的阻滞时间.评估坐骨神经阻滞情况.结果 D组定位失败率为10％.S组阻滞成功率为93％,D组阻滞成功率为96％,2组阻滞成功率比较差异无统计学意义(P＞0.05).与S组比较,D组感觉阻滞和运动阻滞起效时间缩短,操作完成时间延长(P＜0.05),总的阻滞时间、感觉阻滞和运动阻滞维持时间差异无统计学意义(P＞0.05).结论下肢手术患者行坐骨神经阻滞时推荐采用单次注射局麻药.
목적 비교단차주사법여쌍차주사법행좌골신경조체적효과.방법 택기행단측족과수술환자60례,ASA분급Ⅰ혹Ⅱ급,성별불한,년령18 ～ 64세,체중48～72 kg,채용수궤수자표법,장기분위2조(n=30):단차주사조(S조)화쌍차주사조(D조).채용Labat-winnie입로재신경자격의인도하행좌골신경조체.S조출현배굴혹척굴시,주사0.5％라고잡인30 ml;D조출현배굴화척굴시,각주사0.5％라고잡인15 ml.기록정위실패정황.기록조작완성시간、감각조체화운동조체기효급유지시간、총적조체시간.평고좌골신경조체정황.결과 D조정위실패솔위10％.S조조체성공솔위93％,D조조체성공솔위96％,2조조체성공솔비교차이무통계학의의(P＞0.05).여S조비교,D조감각조체화운동조체기효시간축단,조작완성시간연장(P＜0.05),총적조체시간、감각조체화운동조체유지시간차이무통계학의의(P＞0.05).결론 하지수술환자행좌골신경조체시추천채용단차주사국마약.
Objective To compare the single-and double-injection techniques for sciatic nerve block.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 48-72 kg,undergoing elective unilateral foot and ankle surgery,were randomly divided into 2 groups (n =30 each) using a random number table:single-injection group (group S) and double-injection group (group D).Labat-winnie approach to sciatic nerve block was performed under the guidance of a nerve stimulator.When ankle dorsal or plantar flexion developed,group S received a single injection of 0.5％ ropivacaine 30 ml.When ankle dorsal and plantar flexion developed,0.5％ ropivacaine 15 ml was injected each time in group D.The failure of location was recorded.The time spent performing the procedure,onset time and duration of sensory and motor blockade,and the total time for the block were recorded.The effectiveness of block (success,failure) was assessed.Results The failure rate of location was 10％ in group D.The success rate of block was 93％ in group S,and was 96％ in group D,and there was no significant difference in the success rate of block between the two groups.Compared with group S,the onset time of sensory and motor blockade was significantly shortened,the time spent performing the procedure was prolonged,and no significant change was found in the total time for the block,duration of sensory and motor blockade in group D.Conclusion Single-injection technique is recommended for the sciatic nerve block in the patients undergoing lower extremity surgery.