时间段和APP疼痛评分对腰丛神经阻滞术后恢复的影响研究  

Study on the effect of time period and APP pain score on postoperative recovery after lumbar plexus block

作　　者：周孜辉[1] 汪小海[2] 施锋[3] ZHOU Zihui;WANG Xiaohai;SHI Feng(Department of Orthopedics,Shanghai General Hospital,Shanghai 200080,China;Department of Anesthesia,Nanjing Drum Tower Hospital,Nanjing,Jiangsu 210008,China;Department of anesthesia,Shanghai General Hospital,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院骨科,上海200080 [2]南京大学医学院附属鼓楼医院麻醉科,南京210008 [3]上海交通大学附属第一人民医院麻醉科,上海200080

出　　处：《重庆医学》2021年第4期644-649,共6页Chongqing medicine

摘　　要：目的探讨日间不同时间段和移动应用程序(APP)疼痛评分对股骨骨折患者超声引导下前路腰丛神经阻滞术后恢复的影响。方法60例超声引导下前路腰丛阻滞的股骨骨折术后患者作为观察对象,根据不同术后疼痛评分法将患者分为观察组和对照组,每组各30例。对照组使用传统纸质疼痛评分方法评估患者术后疼痛感,观察组通过APP评估。于7:00-19:00每2个小时划分患者实施前路腰丛神经阻滞的时间段,比较两组不同时间段术后疼痛评分及平均动脉压(MAP)、心率、首次下床活动时间和术后1 d肌力评分。结果与对照组比较,于07:00-09:00实施腰丛阻滞的观察组疼痛视觉评分表(VAS)评分更低,17:00-19:00更高,差异有统计学意义(P<0.05);于07:00-09:00和17:00-19:00实施腰丛阻滞的观察组VAS评分与其他时间段比较,差异有统计学意义(P<0.05)。两组疼痛数字评分法(NRS)、口述分级评分法(VRS)和修订版面部表情疼痛量表(FPS-R)评分比较,差异无统计学意义(P>0.05)。于17:00-19:00实施腰丛阻滞的两组MAP和心率均明显高于其他时间段,而于07:00-09:00实施腰丛阻滞术后首次下床活动时间更短,17:00-19:00时间更长,差异有统计学意义(P<0.05)。两组术后1 d肌力评分均大于或等于3分,差异无统计学意义(P>0.05)。结论于07:00-09:00和17:00-19:00行腰丛神经阻滞患者的MAP、心率和首次下床活动时间均呈现明显的时间变化特点,APP疼痛评分可以更准确地评估患者术后疼痛的时间段依赖性。Objective To explore the effect of different time periods during daytime circadian and mobile application(APP)on the recovery of patients with femoral fractures after ultrasound-guided anterior lumbar plexus block.Methods Sixty patients with femoral fractures undergoing ultrasound-guided anterior lumbar plexus block anesthesia were selected and divided into the observation group and the control group according to different tim e postoperative pain scores,with 30 cases in each group.The control group used the traditional paper pain scoring method to evaluate the pain in different periods after the operation,and the observation group used APP.From 7:00 to 19:00,the time period for patients to perform anterior lumbar plexus block was divided every 2 hours,compared pain scores,mean arterial pressure(MAP),heart rate,time to get out of bed for the first time,and muscle strength scores of the two groups on the first day after surgery.Results Compared with the control group,visual analogue scale(VAS)score of the observation group who performed lumbar plexus block at 07:00-09:00 was lower,and higher at 17:00-19:00,the difference was statistically significant(P<0.05).VAS score of the observation group who performed lumbar plexus block at 07:00-09:00 and 17:00-19:00 compared with other time periods,the difference was statistically significant(P<0.05).There was no statistically significant difference in numerical rating scale(NRS),verbal rating scales(VRS)and faces pain scale-revised(FPS-R)scores between the two groups(P>0.05).MAP and heart rate of the two groups who performed lumbar plexus block at 17:00-19:00 were significantly higher than other time periods,and the first time to get out of bed after performing lumbar plexus block at 07:00-09:00 was shorter,17:00-19:00 was longer,the difference was statistically significant(P<0.05).The muscle strength scores of the two groups were more than or equal to 3 points on the first day after surgery,the difference was not statistically significant(P>0.05).Conclusion MAP,heart rate

关 键 词：时间因素 移动应用 股骨骨折 罗哌卡因 前路腰丛阻滞 疼痛 手术后 疼痛测定 

分 类 号：R683.42[医药卫生—骨科学]