目的 观察老年患者髋关节置换手术中应用超声引导下髂筋膜间隙阻滞的麻醉效果和术后阵痛效果。方法 回顾性分析2018年1月—2021年1月收治的80例髋关节置换手术的老年患者,观察组40例选择超声引导下髂筋膜间隙阻滞,对照组40例不进行髂筋膜间隙阻滞。对比不同时间点疼痛评分检测值,手术后不同时间患肢运动阻滞Bromage评分监测、不良反应评定值。结果 观察组术后6、12、24、48 h疼痛评分低于对照组,组间对比(P<0.05);手术完成后的2、24、48 h,两组患肢运动阻滞Bromage评分无差异(P>0.05);观察组不良反应率低于对照组(P<0.05)。结论 对于收治的髋关节置换手术的老年患者在治疗过程中开展超声引导下髂筋膜间隙阻滞,术后的镇痛效果更显著,且也不会造成不良反应,不影响术后患肢运动阻滞,预后理想。
Objective To observe the effect of ultrasound-guided fascia iliac space block on anesthesia and postoperative pain in elderly patients undergoing hip arthroplasty. Methods From January 2018 to January 2021, a total of 80 elderly patients with hip replacement surgery were randomly selected and divided into two groups. Forty cases in the study group were treated with ultrasound-guided fascia iliac space block, and another 40 cases in the control group were not given fascia iliac space block. Pain score, Bromage score of affected limbs, and adverse reactions were evaluated at different time points after operation. Results The pain scores of the study group at 6, 12, 24 and 48 h after operation were lower than those of the control group (P<0.05). At 2, 24, and 48 h after operation, there was no difference in Bromage score of motor block between the two groups (P>0.05). The adverse reaction rate of the study group was lower than that of the control group (P<0.05). Conclusion Ultrasound-guided fascia iliac space block in the treatment of elderly patients undergoing hip replacement surgery has a significant postoperative analgesic effect, and does not cause adverse reactions or affect the postoperative limb motor block, showing ideal prognosis.
[1] 刘绪华,谢珏,袁从旺,等.超声引导下髂筋膜间隙阻滞在老年患者全髋关节置换术中的应用[J].临床麻醉学杂志,2022,38(4):356-360.
[2] 杨顺. 超声引导下髂筋膜间隙阻滞联合罗哌卡因加右美托咪定在老年髋关节置换患者中的镇痛效果研究[J].黑龙江医学,2022,46(2):133-135.
[3] 肖瑛,鲁应军.超声引导髂筋膜间隙阻滞联合骶丛神经阻滞复合喉罩全麻在老年髋关节置换术中的应用效果观察[J].贵州医药,2021,45(7):1054-1055.
[4] 聂亮,胡芸,曾丽.超声引导下髂筋膜间隙阻滞复合浅全麻在老年髋关节置换术中的麻醉效果及对术后恢复的影响[J].实用医院临床杂志,2021,18(4):212-216.
[5] 杨荣国,樊林滨.超声引导下不同剂量右美托咪定复合罗哌卡因髂筋膜间隙阻滞在老年全髋关节置换术中的应用[J].海南医学,2021,32(10):1272-1275.
[6] 张高娇,林小雷,张归帆.超声引导下髂筋膜间隙阻滞在老年全髋关节置换术患者中镇痛应用[J].浙江创伤外科,2021,26(2):354-355.
[7] 黄霞,张峰.超声引导下髂筋膜联合腰骶丛神经阻滞在老年髋关节置换术中的应用[J].河南医学研究,2021,30(10):1795-1797.
[8] 孙鹏,马杨,于金花.超声引导下髂筋膜间隙阻滞麻醉结合喉罩下全麻对老年髋关节置换患者镇痛药物使用量及认知功能的影响[J].国际医药卫生导报,2021,27(5):707-711.
[9] 魏南服,王翠宝,陈强,等.超声引导下髂筋膜间隙阻滞联合纳布啡在老年全髋关节置换术患者中的应用效果[J].医疗装备,2020,33(22):13-14.
[10] 李林锋,郑传东,李强,等.超声引导髂筋膜间隙阻滞联合骶丛神经阻滞复合喉罩全麻在老年髋关节置换术中的应用[J].实用医院临床杂志,2020,17(4):57-59.