小儿股骨干骨折中髂筋膜腔隙神经传导阻滞与全身静脉镇痛作用的比较  

Fascia Iliaca Compartment Nerve Block Versus Systemic Pain Control for Acute Femur Fractures in the children

作　　者：王金山[1] 武永刚[1] 

机构地区：[1]巴彦淖尔市医院,内蒙古包头020000

出　　处：《疾病监测与控制》2015年第11期772-775,共4页Journal of Diseases Monitor and Control

摘　　要：目的探讨使用髂筋膜间隙神经阻滞(FICNB)与全身静脉注射镇痛药镇痛在儿童急性股骨骨折中优缺点。方法从临床镇痛效果、使用频率、镇痛效果及不良反应等方面对71例急性股骨骨折儿童使用髂筋膜间隙神经阻滞(FICNB)与全身静脉注射镇痛药镇痛进行回顾性研究。结果 FICNB组在镇痛效果、镇静效果上均优于全身静脉镇痛(P<0.05);FICNB组在给药频率、不良毒副作用上均低于全身静脉镇痛(P<0.05)。结论罗哌卡因连续髂筋膜腔隙阻滞用于小儿急性股骨骨折手术后镇痛效果好,药物毒副作用少,是一种有效安全的镇痛方法。Objective To compare management of acute femur fractures in children who received a fascia iliaca compartment nerve block（FICNB） to those who received systemic intravenously administered analgesics in the pediatric emergency department. The comparison evaluated frequency of use, effectiveness, and associated adverse event profiles. Methods Study population was derived from a retrospective chart review of pediatric patients sustaining acute femur fractures between 2005 and 2009. Cases（received FICNB） were compared with controls（only systemic analgesia） in terms of effectiveness and adverse event. Outcomes included total doses of systemic medications received and comparison of preintervention and postintervention pain scores. Results Two hundred fifty-nine charts were reviewed： 158 who received FICNB versus 101 who did not. The median dose of systemic medications was 1 dose lower in the FICNB group compared with the systemic medications group. This remained significant after controlling for age and preintervention pain scores（P=0.02）. Median postintervention pain scores in the FICNB group were 1.5 points lower than those in the systemic medications group. This remained significant while controlling for preintervention pain scores and age（P G 0.01）. There was no difference in the total adverse events between the FICNB and the control group in either the unadjusted or adjusted analyses（P=0.08）. The FICNB group had 2 seizure episodes, one of which had associated subarachnoid hemorrhage. No patient in either group experienced bradycardia, arrhythmia, visual disturbance, abnormal hearing, mouth numbness, motor tremors, pain or bleeding at injection site, or prolonged nerve block. Conclusions We report on the largest number of FICNBs administered in a pediatric emergency department for acute femur fractures. Effectiveness, as measured by pain scores and total doses of systemic analgesia, was improved in the FICNB group versus the control. There was no difference in adverse events between the gro

关 键 词：小儿股骨骨折 髂筋膜腔隙神经传导阻滞 

分 类 号：R726.8[医药卫生—儿科]