超声引导腹股沟韧带上髂筋膜阻滞对单侧大隐静脉剥脱术术后镇痛效果的影响  

Effect of ultrasound-guided supra-inguinal fascia iliaca compartment block on analgesia of unilateral great saphenous vein stripping surgery

作　　者：孙西龙 罗佳佳 吴志林[1] SUN Xilong;LUO Jiajia;WU Zhilin(Department of Anesthesia,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,武汉430022

出　　处：《临床外科杂志》2021年第2期191-194,共4页Journal of Clinical Surgery

摘　　要：目的评价超声引导腹股沟韧带上髂筋膜阻滞对单侧大隐静脉剥脱术术后镇痛效果。方法 2019年5月~2020年9月择期行单侧大隐静脉剥脱术病人60例,按照随机数表法分为两组,每组各30例。观察组在全麻诱导前行单次超声引导腹股沟韧带上髂筋膜阻滞;对照组直接行全身麻醉。两组病人均在全身麻醉下完成手术,术后镇痛方案为舒芬太尼静脉自控镇痛(PCIA)。记录术后1小时、4小时、8小时、24小时和48小时视觉模拟疼痛评分(VAS)、PCIA按压次数、舒芬太尼累计用量、补救镇痛情况和相关不良反应发生情况。结果观察组术后1小时、4小时、8小时、24小时和48小时VAS评分分别为1.5±0.9,1.6±0.9,1.8±0.9,1.5±0.8,1.3±0.8,对照组分别为3.1±0.9,3.2±0.8,2.6±0.7,2.4±0.6,2.3±0.7,两组比较差异有统计学意义(P<0.05);观察组术后1小时、4小时、8小时、24小时PCIA按压次数分别为0.6±0.8,1.3±1.1,1.6±1.3,0.9±1.1,对照组分别为2.2±0.9,3.2±1.4,3.4±1.5,2.6±1.7,两组比较差异有统计学意义(P<0.05);术后48小时内舒芬太尼总用量(98.5±2.2)μg较对照组(102.3±1.9)μg明显减少(P<0.05);两组间不良反应发生率比较无明显差异(P>0.05)。结论超声引导腹股沟韧带上髂筋膜阻滞对大隐静脉剥脱术术后具有较好的镇痛效果,显著减少术后舒芬太尼的用量。Objective To observe the effect of ultrasound-guided supra-inguinal fascia iliaca compartment block on analgesia of unilateral great saphenous vein stripping surgery.Methods Sixty patients who underwent elective unilateral great saphenous vein stripping operation from May 2019 to September 2020 were selected and divided into two groups according to the random number table(RNT) method, 30 cases in each group.The operations in both groups were completed under general anesthesia.The observation group received a single ultrasound-guided supra-inguinal fascia iliaca compartment block before the induction of general anesthesia;While the control group was not treated.Patient controlled intravenous sufentanil administration was used for postoperative analgesia.VAS pain scores, PCIA compression times, cumulative sufentanil consumption, salvage analgesia and related adverse reactions were recorded at 1 h, 4 h, 8 h, 24 h and 48 h after operation.Results The VAS scores of the observation group at 1 h, 4 h, 8 h, 24 h and 48 h after operation was 1.5±0.9,1.6±0.9,1.8±0.9,1.5±0.8,1.3±0.8,respectively.There were all significantly lowerthan control group(3.1±0.9,3.2±0.8,2.6±0.7,2.4±0.6,2.3±0.7)(P<0.05).The times of PCIA pressing at 1 h, 4 h, 8 h, and 24 h in the observation group were 0.6±0.8,1.3±1.1,1.6±1.3,0.9±1.1,respectively, while in control group were 2.2±0.9,3.2±1.4,3.4±1.5,2.6±1.7,respectively.There were significantly difference in the two groups(P<0.05).During 48 h after the operation, the cumulative sufentanil consumption in the observation group [(98.5±2.2)μg] compared with control group [(102.3±1.9)μg] was significantly difference(P<0.05).There were no significant difference in terms of the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ultrasound-guided supra-inguinal fascia iliaca compartment block has a good analgesic effect for great saphenous vein stripping operation, and significantly reduces the amount of post operation opioid drugs consumption, which indicates tha

关 键 词：大隐静脉剥脱术 腹股沟韧带上髂筋膜阻滞 术后镇痛 

分 类 号：R654.4[医药卫生—外科学]