摘要
目的:分析超声引导下髂筋膜间隙阻滞与全麻在老年全髋关节置换术中的效果。方法:回顾性分析2020年10月—2023年6月辽阳市中心医院收治的实施全髋关节置换术的86例老年患者的临床资料,根据其麻醉方法分为髂筋膜间隙阻滞组(n=43)与常规全麻组(n=43)。比较两组患者手术情况(手术时间、术中出血量),术中生命体征[心率(HR)、平均动脉压(MAP)],术后疼痛度[数字评价量表(NRS)],术后情况[自控静脉镇痛泵(PCIA)有效按压次数、首次下床时间、住院时间]及麻醉不良反应总发生率。结果:两组患者手术时间、术中出血量比较差异均无统计学意义(P>0.05)。麻醉前、手术结束时两组患者HR、MAP比较差异均无统计学意义(P>0.05);插管时、假体植入时髂筋膜间隙阻滞组患者MAP、HR均显著低于常规全麻组,差异均有统计学意义(P<0.05)。术后3、6、12 h时髂筋膜间隙阻滞组患者NRS评分均显著低于常规全麻组,差异均有统计学意义(P<0.05);术后48 h时两组患者NRS评分比较差异无统计学意义(P>0.05)。髂筋膜间隙阻滞组患者术后PCIA有效按压次数少于常规全麻组、首次下床时间早于常规全麻组、麻醉不良反应总发生率显著低于常规全麻组,差异均有统计学意义(P<0.05);两组患者住院时间比较差异无统计学意义(P>0.05)。结论:超声引导下髂筋膜间隙阻滞可提高老年全髋关节置换术患者镇痛效果,减少镇痛药物使用,并降低麻醉不良反应发生风险。
Objective:To analyze the effect of ultrasound-guided iliac fascial space block and general anesthesia in elderly patients with total hip replacement.Method:The clinical data of 86 elderly patients undergoing total hip replacement in Liaoyang City Central Hospital were retrospectively analyzed from October 2020 to June 2023,and the patients were divided into iliac fascial space block group(n=43)and routine general anesthesia group(n=43)according to the anesthesia methods.The two groups of patients were compared in terms of surgical conditions(surgical time,intraoperative blood loss),intraoperative vital signs[heart rate(HR),mean arterial pressure(MAP)],postoperative pain degree[numerical rating scale(NRS)],postoperative conditions[effective compression frequency of patient-controlled intravenous analgesia(PCIA)pump,first ambulation time,hospital stay]and total incidence rate of anesthesia adverse reactions.Result:There were no statistically significant differences in surgical time and intraoperative blood loss between the two groups of patients(P>0.05).There were no statistical differences in HR and MAP between both groups before anesthesia and at the end of surgery(P>0.05).MAP and HR in iliac fascial space block group during intubation and prosthesis implantation were significantly lower than those in routine general anesthesia group,with statistical differences(P<0.05).NRS scores were significantly lower in iliac fascial space block group than those in routine general anesthesia group at 3 h,6 h and 12 h after surgery,with a statistical significance(P<0.05).There was no statistical difference in NRS score between the two groups at 48 h after surgery(P>0.05).The effective compression frequency of postoperative PCIA in the iliac fascia space block group was less than that in the routine general anesthesia group,the first time of getting out of bed was earlier than that in the routine general anesthesia group,and the total incidence of anesthesia adverse reactions was significantly lower than that in the routine general anesthesia group,with statistical significance(P<0.05);there was no statistical significance in hospital stay between the two groups(P>0.05).Conclusion:Ultrasound-guided iliac fascial space block can improve the analgesic effect,reduce the use of analgesic drugs,and reduce the risk of anesthesia adverse reactions in elderly patients with total hip replacement.
作者
卢想
王芳
刘冰
LU Xiang;WANG Fang;LIU Bing(Department of Anesthesiology,Liaoyang City Central Hospital,Liaoyang 111000,China;不详)
出处
《中国医学创新》
CAS
2024年第3期56-60,共5页
Medical Innovation of China
关键词
髂筋膜间隙阻滞
全麻
老年全髋关节置换术
麻醉效果
镇痛
Iliac fascial space block
General anesthesia
Elderly total hip replacement
Anesthetic effect
Analgesia
作者简介
通信作者:卢想。
