连续股神经阻滞镇痛对老年髋部骨折患者术后谵妄的影响  

作　　者：李翃斌[1] 胡佳艳[1] 张燕 梁磊[1] 张文静 

机构地区：[1]浙江省舟山医院,316000

出　　处：《浙江临床医学》2020年第4期528-529,532,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生一般研究计划项目(2016KYA182)。

摘　　要：目的探讨持续股神经阻滞对老年髋部手术患者术后谵妄的影响.方法以122例单侧髋部骨折患者为观察对象,根据镇痛方法不同将其分为两组,分别接受罗哌卡因持续股神经阻滞(CFNB组,60例)和吗啡静脉自控镇痛(PCIA组,62例).对比两组术后7d内发生术后谵妄情况,利用视觉模拟量表(VAS)评分评估疼痛严重程度等指标情况.结果两组患者术后静息VAS评分差异不存在统计学意义(P>0.05);CFNB组不良反应发生率为11.67%,PCIA组为33.87%,差异存在统计学意义(P<0.05);CFNB组患者术后运动VAS评分比PCIA组低,差异有统计学意义(P<0.05);CFNB组谵妄发生率(25%)明显低于PCIA组(43.6%),差异存在统计学意义(P<0.05).结论持续股神经阻滞术后镇痛降低老年髋部手术患者术后谵妄的发生率.Objective To study the effects of continuous femoral nerve block on postoperative delirium in elderly patients undergoing hip surgery.Methods 122 patients with unilateral hip fracture were divided into two groups according to different analgesic methods and received continuous femoral nerve block with ropivacaine(CFNB group,60 cases).Patient controlled intravenous morphine analgesia(PCIA group,62 cases).The postoperative delirium occurred within 7 days after operation was compared between the two groups,and the pain severity and other indicators assessed by visual analogue scale(VAS)score were used.Results There was no statistical difference in VAS score between the two groups(P>0.05).The incidence of adverse reactions were 11.67% in CFNB group and 33.87% in PCIA group,the difference was statistically significant(P<0.05).The postoperative VAS score of patients in CFNB group was lower than that in PCIA group,and the difference was statistically significant(P<0.05).The incidence of delirium in CFNB group(25%)was significantly lower than that in PCIA group(43.6%),and the difference was statistically significant(P<0.05).Conclusion Postoperative analgesia with continuous femoral nerve block decreases the incidence of postoperative delirium in elderly patients undergoing hip surgery.

关 键 词：镇痛 神经阻滞 老年髋部骨折 

分 类 号：R61[医药卫生—外科学]