摘要
目的观察超声引导下持续腰方肌阻滞、持续髂筋膜阻滞和自控静脉镇痛3种镇痛方式分别用于高龄患者髋关节置换术后的镇痛效果。方法选取择期行单侧髋关节置换术的高龄患者93例,分别在术后2 h采用持续腰方肌阻滞组(Ⅰ组)、持续髂筋膜阻滞组(Ⅱ组)或自控静脉镇痛组(Ⅲ组),观察术后1(T_(0))、4(T_(1))、8(T_(2))、12(T_(3))、24(T_(4))、48 h(T_(5))静态和动态疼痛视觉模拟评分(VAS)。结果Ⅰ组和Ⅱ组静态(T_(0)-T_(5))和动态(T_(2)-T_(5))VAS评分明显低于III组(P<0.01或0.05);Ⅰ组需追加盐酸曲马多者少于Ⅲ组,Ⅱ组恶心呕吐发生率低于Ⅲ组(P<0.05),Ⅰ组与Ⅱ组间比较则差异无统计学意义(P>0.05)。结论超声引导腰方肌阻滞和髂筋膜阻滞对高龄患者髋关节置换术后镇痛效果好,可减少阿片类药物使用及不良反应。
Objective To observe the analgesic effect of ultrasound-guided continuous quadratus lumborum block(CQLB),continuous iliofascial block(CIFB)and self-controlled intravenous analgesia(SCIA)on elderly patients following hip replacement.Methods Ninety-three elderly patients undergoing unilateral hip replacement were randomly treated with CQLB(group Ⅰ),CIFB(group Ⅱ)or SCIA(group Ⅲ)at 2 h postoperation.The static and dynamic VAS pain scores were observed at 1(T_(0)),4(T_(1)),8(T_(2)),12(T_(3)),24(T_(4)),48 h(T_(5))following operation.Results The static(T_(0)-T_(5))and dynamic(T_(2)-T_(5))VAS scores were lower in groups Ⅰ and Ⅱ than in group Ⅲ(P<0.01 or 0.05).Compared with group Ⅲ,additional tramadol hydrochloride was less in group Ⅰ,while nausea and vomiting were fewer in group Ⅱ(P<0.05).There was no statistical significance in additional tramadol hydrochloride,nausea and vomiting between group Ⅰ and Ⅱ(P>0.05).Conclusion Postoperative analgesic effects of ultrasound-guided CQLB and CIFB are favorable for elderly patients following hip arthroplasty,which can reduce the use of opioids and adverse reactions.
作者
邓铭锋
何松蓬
廖荣宗
DENG Ming-feng;HE Song-peng;LIAO Rong-zong(Department of Anesthesiology,Sanshui District Hospital of Traditional Medicine,Foshan 528100,China;Department of Anesthesiology,Hospital of Traditional Medicine,Foshan 528000,China)
出处
《广东医科大学学报》
2023年第4期408-412,共5页
Journal of Guangdong Medical University
基金
广东省医学科学技术研究基金项目(B2021271)。
关键词
髋关节置换
腰方肌阻滞
髂筋膜阻滞
镇痛
hip replacement
quadratus lumborum block
iliofascial block
analgesia
作者简介
邓铭锋(1978-),男,硕士,主任医师,E-mail:dengmingfeng05@126.com。
