关键词: 超声引导；股神经；坐骨神经；大隐静脉；神经阻滞

Abstract:

Objective  To evaluate the feasibility of ultrasound-guided combined femoral-sciatic nerve block for patients treated with anticoagulants before operation undergoing the high ligation and stripping of great saphenous vein. Methods  Thirty anticoagulated patients(NB group) and 30 normal coagulation patients(CSEA group) scheduled for unilateral ligation and stripping of great saphenous vein were consecutively chosen in the study. The patients in NB group were operated under ultrasound-guided combined femoral-sciatic nerve block，while the patients in CSEA group were operated under combined spinal and epidural anesthesia.Anesthesia effects, intravenous fluid volume, dosages of local anesthetic, changes of blood pressure and postoperative complications were observed in the two groups. Results  The anesthesia and operation procedures were all successful for all patients in both groups. Both of the success rates in the two groups were 100%. During anesthesia, blood pressure in NB group was more stable than that in CSEA group (P<0.01). Seven patients in CSEA group were treated with ephedrine for low blood pressure while no patient in NB group needed vasoconstrictor. Average intravenous fluid volume in NB group was less than that in CSEA group［(878±68) mL vs (1226±269) mL, P<0.01］. Average ropivacaine dosages in NB and CSEA group were 150 mg and 15 mg, respectively. Eight patients suffered from postoperative nausea and vomit and 5 patients suffered from urinary retention in CSEA group, while no patient suffered those symptoms in NB group. Conclusion  Ultrasound-guided combined femoral-sciatic nerve block may totally meet the anesthetic requirement of patients treated with anticoagulants undergoing high ligation and stripping of great saphenous vein.

Key words: Ultrasound-guided; Femoral nerve; Sciatic nerve; Great saphenous vein; Nerve block