Total knee replacement surgery lumbar plexus - the clinical application of sciatic nerve block combined


After 5min (T1), 10rain (T2), 20mm (rI3), 30m ~ n (T4), 60min (T5), when the heart rate (HR),uggs Günstig, systolic blood pressure (sP), diastolic blood pressure (DP). The injection is completed the starting point for research evaluation, the patient complained of pain in the wound to evaluate the need for postoperative pain treatment end. Determination of the use of sensory nerve block needle case. Motor block using a modified Bromage scale (0 is divided into normal; 1 point: You can not lift the straight leg, but the knee and ankle joints can be active; 2: You can not lift the leg straight, not bent the knee, but can be active ankle; 3: You can not lift the straight leg,diesel jeans outlet, can not bend the knee and ankle joints). Recorded sensory nerve block onset time (T1),nike store, motor block onset (up Bromage1 minutes after injection), time (rI2), sensory / motor block duration (rI3, T4),abercrombie sale, and recorded after 24h nausea, vomiting, headache, urinary retention and other adverse reactions. 1.4 Statistical analysis SPSS10.0 statistical software,moncler outlet, measurement data (x ± s), said the group two-factor analysis of variance was used to compare between the two groups were compared using ANOVA, count data y test. 2 Results 2.1 Comparison of hemodynamic two groups Group A rI2 and 1DsP, DP decreased (P <0.01); B group at each time point DP, SP, HR difference was not statistically significant, see Table 1. Author: 316100, Zhejiang Province, Zhoushan City, United Christian Hospital for Orthopedics in Table 1 two different time points before and after injection of hemodynamic Note: Compared with. 1I] comparison, P <0.012.2 two sets of sensory and motor block were compared between the rI11, rI2 difference was not significant; rI3, T4B group was longer than group A (P <0.01). In Table 2. Table 2 sets of sensory and motor nerve block by comparison (± s) Note: A group. P <0.012.3 after 24h in group A 3 cases of adverse reactions, nausea, vomiting, 2 cases of urinary retention; B group, no adverse reactions. 3 Discussion The results show, A group 10min after injection, blood pressure, hemodynamic fluctuations, while the B group stable, it is because the role of spinal anesthesia is at the level of spinal nerve axon, blocking the sympathetic nerve efferent fibers, which led to resistance vessels and capacitance vessels of the expansion, thy blood less, resulting in decreased blood pressure, while peripheral nerve blocks, peripheral nerve function in the area, had no effect on the sympathetic, but limited to one block side, less impact on hemodynamics. Two sets of sensory and motor block onset time difference was not significant, indicating that nerve stimulator guided peripheral nerve block, rapid onset, the reason may be related to administration of the site and the dispersion of drugs, coupled with the use of nerve stimulator positioning technology, when the minimum current output caused by muscle contraction, indicating that the tip is close to the target nerve, local anesthetic given at this time, not only block success rate, while the diffusion process anesthetic significantly reduced. Group B, sensory and motor block longer than in group A, may be related to the type of nerve block and injection volume. Two degree of motor block was no significant difference, indicating that a lumbar plexus block combined sciatic nerve block for lower limb function is perfect. Lumbar plexus is mainly dominated by lower extremity femoral nerve, lateral femoral cutaneous nerve and obturator nerve, lumbosacral plexus main nerves of the sciatic nerve. Lumbar plexus block will have a waist gap All parts of lumbar nerve of the sacral nerve block and block, but the position of the nerve block, lumbar plexus block located close to the spinal nerve roots, the effect is close to the spinal resistance stagnation, and thus a sciatic nerve combined lumbar plexus block for lower limb sensory and motor block better L3J. A group of patients with headache, nausea and incidence of urinary retention may be related to a wide range of block anesthesia, blood pressure, leading to cerebral ischemia and the vagus nerve increases peristalsis and other factors.