连续腰丛神经阻滞用于髋关节置换术的术后镇痛效果  

Postoperative analgesia with continuous lumbar plexus block in patients after hip replacement

作　　者：黄炳强[1] 毛庆祥[1] 闫红[1] 刘宿[1] 陈力勇[1] 

机构地区：[1]第三军医大学大坪医院麻醉科,重庆市400042

出　　处：《实用疼痛学杂志》2014年第4期286-289,共4页Pain Clinic Journal

摘　　要：目的 比较连续腰丛神经阻滞、硬膜外和静脉术后镇痛用于髋关节置换术后的效果.方法 单侧髋关节置换术患者75例,随机分为连续腰丛阻滞组（N组）,硬膜外术后镇痛组（E组）,静脉术后镇痛组（Ⅴ组）,每组25例.于术后各时点记录3组患者的VAS评分、HR、MAP和呼吸频率（RR）,以及术后开始进食的时间、术后不良反应与患者满意度.结果 3组患者术后各时点静息与运动时VAS评分、HR、MAP和RR的差异无统计学意义（P＞0.05）;N组患者术后开始进食的时间早于E组和V组（P＜0.05）;Ⅴ组患者术后不良反应发生率高于N组和E组（P＜0.05）.结论 连续腰丛神经阻滞术后镇痛可为单侧髋关节置换手术患者提供完善的术后镇痛,且不良反应少.Objective To compare the postoperative analgesia efficacy among continuous lum- bar plexus block, epidural analgesia and intravenous analgesia in patients after unilateral hip replacement. Methods Seventy-five patients underwent selective unilateral hip replacement were randomly divided into 3 groups： continuous lumbar plexus block （N）, patient-controlled epidural analgesia （E） and patient-controlled intravenous analgesia （V）, 25 cases in each group. VAS, HR, MAP, RR, postoperative eating time, complications and patient＇s satisfaction were recorded after the operation. Results No significant differences were found in VAS, HR, MAP, RR among the 3 groups （P〉0.05）. Postoperative eating time in group N was significantly earlier than that in the other groups（P〈0. 05）. The incidence of adverse effects in group V was significantly higher than that in group E and N（P〈0.05）. Conelusian Continuous lumbar plexus block can provide satisfactory postoperative analgesia for unilateral hip replacement with fewer adverse effects.

关 键 词：神经传导阻滞 腰丛神经 关节成形术 置换 髋 疼痛 手术后 镇痛 患者控制 

分 类 号：R971.2[医药卫生—药品]