经超声引导下股神经阻滞在髋部骨折患者围术期术前镇痛中的应用  

Application of ultrasound-guided femoral nerve block in perioperative analgesia of hip fracture patients

作　　者：刘庆华[1] 周余旺[1] 刘雪平[1] 姜露露 方剑[1] LIU Qinghua;ZHOU Yuwang;LIU Xueping(People’s Hospital of Quzhou City,Quzhou 324000,China)

机构地区：[1]衢州市人民医院超声科,浙江衢州324000

出　　处：《全科医学临床与教育》2021年第5期418-420,共3页Clinical Education of General Practice

基　　金：2019年衢州市科技计划指导性项目(2019051)。

摘　　要：目的探讨经超声引导下股神经阻滞在髋部骨折患者围术期术前镇痛中的应用价值。方法选择择期行髋部骨折手术的患者126例,采用随机数字表法分为研究组和对照组,每组63例,研究组术前镇痛采用经超声引导下骨神经阻滞,对照组采用静脉注射舒芬太尼。比较两组患者围术期不同时间点心率(HR)、平均动脉压(MAP)以及血氧饱和度(SpO2)以及术前镇痛后视觉模拟评分(VAS)和警觉/镇静(OAA/S)评分情况和用药后不良反应发生情况。结果对照组在体位摆放前HR均低于入院时和体位摆放时的,差异均有统计学意义(t分别=3.17、2.87,P均<0.05),研究组体位摆放前的HR高于对照组体位摆放前,差异有统计学意义(t=2.77,P<0.05);研究组术前镇痛后OAA/S评分低于对照组,差异有统计学意义(t=9.06,P<0.05);研究组用药后不良反应发生率低于对照组,差异有统计学意义(χ^(2)=8.23,P<0.05)。结论与舒芬太尼对髋部骨折患者术前镇痛中的作用相比,经超声引导下股神经阻滞的镇静效果更佳,并可降低用药后不良反应发生率。Objective To explore the application of ultrasound-guided femoral nerve block in perioperative preoperative analgesia for hip fracture patients.Methods One hundred and twenty-six patients undergoing elective hip fracture surgery were selected and divided into the study group and control group by random number table method with 63 cases in each group.The preoperative analgesia of the study group was performed by ultrasound-guided bone nerve block.The control group received intravenous injection of sufentanil.The heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO2),visual analog scale(VAS)and modified observer’s assessment of alertness/sedation(OAA/S)after preoperative analgesia,reversed actions between the two groups at different times during the perioperative period were compared.Results The HR of the control group before position were lower than that at admission and when positioning(t=3.17,2.87,P<0.05).The HR of the study group before position was higher than that before position(t=2.77,P<0.05).The OAA/S score of the study group after analgesia was lower than that of the control group(t=9.06,P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(χ^(2)=8.23,P<0.05).Conclusion Compared with the effect of sufentanil on preoperative analgesia in patients with hip fractures,ultrasound-guided femoral nerve block has a better sedative effect with lower incidence of adverse reactions.

关 键 词：神经阻滞 术前镇痛 髋部骨折 超声引导 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]