摘要 目的 探讨超声引导股骨近端一针两点技术（single-penetration dual-injection SPEDI）技术用于老年膝关节以下手术的安全性、便捷性，有效性。方法 选择行膝关节以下手术的老年病人80例,随机分为两组组，一针两点技术组（A组）、腘窝坐骨神经联合隐神经阻滞组（B组），超声引导下使用0.5%盐酸罗哌卡因20ml和5ml行坐骨神经及隐神经阻滞，记录两组操作时间，两组入室给予镇静药后、操作时间，切皮时、手术结束时的收缩压、舒张压和心率，评估注药后10、20、30min时感觉阻滞、运动阻滞及术中使用舒芬太尼情况。 结果 A组操作时间显著短于B组（P<0.05），操作时A组血流动力学平稳（P<0.05），腓肠神经在注药后20min、30min，胫神经在注药后30min的感觉阻滞B组高于A组（P<0.05），运动阻滞及术中舒芬太尼需要量无差异（P>0.05）。结论 一针两点技术在老年膝关节以下手术中操作便捷、安全有效，值得在临床上广泛推广。
【Abstract】 Objective：To discuss the safety,effectiveness and convenience of the single-penetration dual-injection method useing in elderly operation under knee joint operationChoosing 80 cases of elderly patients who have the below the knee surgery，and were randomly divided into three groups，SPEDI group (group A) and popliteal fossa sciatic nerve joint saphenous nerve block group (group B)．using 0.5% ropivacaine 20ml and 5ml with sciatic nerve and saphenous nerve block．Record the two groups of operation time，burglary given sedative，operation time，skin incision， operation at the end of the contraction pressure，diastolic blood pressure and heart rate， evaluation after the injection of 10，20，30 min sensory and motor blockade and need the amount of sufentanil in surgery．RESULTS：The block execution time of A group was significantly shorter than B group (P<0.05)，the hemodynamics of A group was more stable than group B during operation (P<0.05)，there was a difference in the rate of sensory block (P<0.05) within 30 minutes，motor block and sufentanil need was no difference (P>0.05)．CNCLUSION：SPEDI method is convenient, safe and effective in elderly surgery under knee, it is worth to be widely used in clinical．
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