论文部分内容阅读
Anterior cruciate ligament(ACL)reconstruction provokesandextreme peri-and post-operative pain when the regional block is unsuccessful.Theability oflumbar plexusand sciatic nerve block in combination often failto provide satisfactoryanaesthesiain patients undergoinganterior cruciateligament reconstruction.Our objective was to evaluate theanesthesiaof theobturator nerveafter different combinations recommended for the lower limbin this particular surgery.
60patients(ASAⅠ-Ⅲ,18to65years ofage,BMI18.5to24)undergoing unilateralarthroscopic cruciate ligament reconstruction wererandomly divided into three groups(GroupA,group Band group C).Patientsof groupAunderwent blockade of lumbar plexus+sciatic nerve block(n=20).Patients of group B(n=20)combined the blockade of the lumbarand sacral plexus,with ultrasound-guided para-sacralapproach(PSNB).Patients of group C(n=20)received blockade of the lumbar plexusfeaturing posterior sciatic nerve blockand obturator nerve block(ONB).Blocks were performed using1％Lidocaine plus0.4％Ropivacaine.Thenwe compared the three groups based on the time of performance,quality ofanesthesiaas wellas the incidence of complications.Anesthetic effects weremeasuredat the time points of5,10,20and30minutesafter the completionof localanesthetics injection.The blockade of obturator nerve wasassessedby the measurement ofadductor strength.
Result：The three groups had comparable demographicaland surgicalcharacteristics.Group B consumed shortest time to perform.Completesensory blockade of the group Band C were not significantly different,butlower in groupA(p<0.05).Theadductor strength values were similar ingroup Band C,but were lower in groupA(p<0.05).No significantdifferences in incidenceand complications were encountered between groups.However,group Band C showed to have lesser puncture sites.
Conclusion：This clinical study demonstrated that PSNB,in combinationwith lumbar plexus block emphasized the blockade of the obturator nerve,provideadequateanesthesiaforanterior cruciate ligament reconstructionsurgeryand do not increase the incidence ofanesthetic complications.
60patients(ASAⅠ-Ⅲ,18to65years ofage,BMI18.5to24)undergoing unilateralarthroscopic cruciate ligament reconstruction wererandomly divided into three groups(GroupA,group Band group C).Patientsof groupAunderwent blockade of lumbar plexus+sciatic nerve block(n=20).Patients of group B(n=20)combined the blockade of the lumbarand sacral plexus,with ultrasound-guided para-sacralapproach(PSNB).Patients of group C(n=20)received blockade of the lumbar plexusfeaturing posterior sciatic nerve blockand obturator nerve block(ONB).Blocks were performed using1％Lidocaine plus0.4％Ropivacaine.Thenwe compared the three groups based on the time of performance,quality ofanesthesiaas wellas the incidence of complications.Anesthetic effects weremeasuredat the time points of5,10,20and30minutesafter the completionof localanesthetics injection.The blockade of obturator nerve wasassessedby the measurement ofadductor strength.
Result：The three groups had comparable demographicaland surgicalcharacteristics.Group B consumed shortest time to perform.Completesensory blockade of the group Band C were not significantly different,butlower in groupA(p<0.05).Theadductor strength values were similar ingroup Band C,but were lower in groupA(p<0.05).No significantdifferences in incidenceand complications were encountered between groups.However,group Band C showed to have lesser puncture sites.
Conclusion：This clinical study demonstrated that PSNB,in combinationwith lumbar plexus block emphasized the blockade of the obturator nerve,provideadequateanesthesiaforanterior cruciate ligament reconstructionsurgeryand do not increase the incidence ofanesthetic complications.