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首页> 外文期刊>Local and Regional Anesthesia >Combined posterior lumbar plexus–sciatic nerve block versus combined femoral–obturator–sciatic nerve block for ACL reconstruction
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Combined posterior lumbar plexus–sciatic nerve block versus combined femoral–obturator–sciatic nerve block for ACL reconstruction

机译：腰后丛神经-坐骨神经阻滞与股-闭孔-坐骨神经阻滞合并ACL重建

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Background: We compared the efficacy of combined posterior lumbar plexus–sciatic nerve block with that of combined femoral–obturator–sciatic nerve block as anesthesia for anterior cruciate ligament reconstruction surgery, because both block combinations have been recommended for lower limb arthroscopic and reconstructive surgery.Methods: Forty-eight patients undergoing elective unilateral anterior cruciate ligament reconstruction under local anesthesia were randomized to undergo either combined posterior lumbar plexus–sciatic nerve block (Group 1), or combined femoral–obturator–sciatic nerve block (Group 2). Blocks were performed using nerve stimulation and bupivacaine 0.5% mixed with lignocaine 2%. Systolic and diastolic blood pressure, heart rate, and pulse oximetry were recorded. Quality of anesthesia, motor and sensory block, time to first analgesic use, sedation, and need for general anesthesia were recorded, along with verbal postoperative pain scores, and side effects.Results: No patient in Group 1 and two patients in Group 2 needed general anesthesia. Complete sensory blockade was higher in Group 1 than in Group 2. However, complete motor blockade was similar in both groups. In Group 1, verbal pain scores were lower than in Group 2. Time to first analgesic was similar between the two groups. Total analgesic consumption was lower in Group 1. No significant differences were found for heart rate, pulse oximetry, or systolic and diastolic blood pressure between the groups, and no signs of toxicity were encountered.Conclusion: Combined posterior lumbar plexus–sciatic nerve block provided more comfortable intraoperative anesthesia and better postoperative analgesia than combined femoral–obturator–sciatic nerve block for anterior cruciate ligament reconstruction surgery.
机译：背景：我们比较了后腰丛-坐骨神经阻滞联合股骨-闭孔-坐骨神经阻滞联合麻醉在前十字韧带重建手术中的麻醉效果，因为这两种阻滞组合均推荐用于下肢关节镜和重建手术。方法：将48例在局部麻醉下接受选择性单侧前交叉韧带重建的患者随机分为后路腰丛-坐骨神经阻滞（第1组）或股-闭孔-坐骨神经阻滞（第2组）。使用神经刺激和0.5％布比卡因与2％利多卡因混合来进行阻滞。记录收缩压和舒张压，心率和脉搏血氧饱和度。记录麻醉质量，运动和感觉阻滞，首次使用镇痛药的时间，镇静和全身麻醉的需要，以及口头术后疼痛评分和副作用。结果：第1组中无患者，第2组中有2例患者全身麻醉。第1组的完全感觉阻滞高于第2组。但是，两组的完全运动阻滞相似。在第1组中，语言疼痛评分低于第2组。两组之间的首次镇痛时间相似。第1组的总镇痛药消耗较低。两组之间在心率，脉搏血氧饱和度或收缩压和舒张压方面均无显着差异，也未见毒性反应。结论：提供了腰后神经丛-坐骨神经联合阻滞与前交叉韧带重建术相比，股-闭孔-坐骨神经阻滞联合手术更舒适，术中麻醉，术后镇痛效果更好。

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