|
| 超声引导下连续改良腹股沟韧带上髂筋膜阻滞对全髋关节置换术后镇痛效果的影响 |
| Analgesic effect of ultrasound-guided continuous improved suprainguinal fascia iliaca block after total hip arthroplasty |
| |
| DOI：10.12089/jca.2019.10.008 |
| 中文关键词: 超声引导 腹股沟韧带上髂筋膜阻滞 全髋关节置换术 |
| 英文关键词: Ultrasound-guided Suprainguinal fascia iliaca block Total hip arthroplasty |
| 基金项目: |
|
| 摘要点击次数: 3795 |
| 全文下载次数: 1342 |
| 中文摘要: |
目的 观察超声引导下连续改良腹股沟韧带上髂筋膜阻滞在全髋关节置换术后的镇痛效果。
方法 择期全麻下行单侧全髋关节置换术患者60例,男33例,女27例,年龄60～86岁,体重44～82 kg,ASA Ⅰ或Ⅱ级,采用随机数字表法将患者随机分为两组:超声引导下连续改良腹股沟韧带上髂筋膜阻滞组(E组)和静脉自控镇痛组(C组)。E组在全麻诱导前行改良腹股沟韧带上髂筋膜阻滞后留置导管,术后导管接电子泵行连续阻滞镇痛;C组术后使用PCIA。记录术后2、4、6、12、24、36、48 h静息和活动时VAS疼痛评分、曲马多补救镇痛情况、首次下床活动时间、术后镇痛满意度评分和不良反应的发生情况。
结果 术后1～48 h E组活动时VAS疼痛评分明显低于C组(P＜0.05),术后1～36 h E组静息时VAS疼痛评分明显低于C组(P＜0.05)。E组使用曲马多补救镇痛例数明显少于C组[4例（13%） vs 14例(47%)，P＜0.05],首次下床活动时间明显短于C组[（24.2±1.8） h vs (39.7±1.7) h，P＜0.05],术后镇痛满意度评分明显高于C组[（9.0±0.6）分 vs (6.1±0.8)分，P＜0.05],恶心呕吐发生率明显低于C组[3例（10%） vs 11例(37%)，P＜0.05]。
结论 超声引导下连续改良腹股沟韧带上髂筋膜阻滞能提供良好的镇痛,促进患者早期功能锻炼和康复,可作为一种新型的镇痛方式应用于全髋关节置换术后患者的镇痛。 |
| 英文摘要: |
Ojective To observe the analgesic effect of ultrasound-guided continuous improved suprainguinal fascia iliaca block (SIFIB) after total hip arthroplasty.
Methods Sixty patients underwent unilateral total hip arthroplasty under general anesthesia, 33 males and 27 females, aged 60-86 years, weighing 44-82 kg, falling into ASA physical status Ⅰ or Ⅱ, were randomly divided into ultrasound-guided continuous improved SIFIB group (group E) and patient controlled intravenous analgesia group (group C). Group E received modified SIFIB before induction of general anesthesia, then the catheter was indwelled. After the operation, the catheter was connected with electronic pump for continuous block analgesia. Patient controlled intravenous analgesia after operation was used in group C. The resting and active VAS scores 2, 4, 6, 12, 24, 36 and 48 h after surgery, the number of tramadol remedies for analgesia, the time of the first ambulation, the satisfaction of postoperative analgesia effect and the occurrence of nausea and vomiting were recorded.
Results The VAS scores within 1-48 h after surgery in group E at activity were significantly lower than those in group C (P < 0.05), while the VAS scores at rest in group E within 1-36 h after surgery were significantly lower than those in group C (P < 0.05). Group E used less tramadol to relieve pain compared with group C [4 cases （13%） vs 14 cases (47%)， P ＜ 0.05]. The time required for the first time to get out of bed in group E was significantly shorter than that in group C [（24.2 ± 1.8） h vs (39.7 ± 1.7) h， P ＜ 0.05]. The postoperative analgesia satisfaction of group E was significantly higher than that in group C [（9.0 ± 0.6） scores vs (6.1 ± 0.8) scores， P ＜ 0.05]. The incidence of nausea and vomiting in group E was significantly lower than that in group C [3 cases （10%） vs 11 cases (37%)， P ＜ 0.05].
Conclusion Ultrasound-guided continuous modified SIFIB can effectively provide good analgesia, promote early functional exercise and rehabilitation of patients, thus it can be used as a new type of adjuvant analgesia for patients after total hip arthroplasty. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
