腹股沟韧带上连续髂筋膜间隙阻滞在髋关节置换术后镇痛中的应用  

Supra-inguinal fascia iliaca compartment block as an analgesia technique for patients undergoing hip arthroplasty

作　　者：吴克义[1] 叶枝秀 唐朝亮 胡成云 柯德声 WU Ke-yi;YE Zhi-xiu;TANG Chao-liang(Anhui Lujiang General Hospital,Hefei 231500,Anhui;The First Affiliated Hospital of USTC,Hefei 230001,Anhui)

机构地区：[1]庐江县人民医院麻醉科,安徽合肥231500 [2]中国科学技术大学附属第一医院麻醉科,安徽合肥230001

出　　处：《安徽卫生职业技术学院学报》2021年第3期24-26,共3页Journal of Anhui Health Vocational & Technical College

基　　金：中央高校基本科研业务费专项资金资助(编号:WK9110000044)。

摘　　要：目的:观察超声引导下腹股沟韧带上入路连续髂筋膜间隙阻滞在髋关节置换术后镇痛中的效果。方法:将67例接受髋关节置换手术患者随机分为静脉镇痛V组34例,连续髂筋膜间隙阻滞镇痛I组33例,观察两组患者术后24 h患肢主动运动VAS疼痛评分、补救性镇痛药物使用剂量、恶心呕吐发生率、简易精神状态量法(MMSE)评分、手术结束后开始主动活动时间以及患侧肢体肌力评估(患肢肌力评估4级及以上比例)以及患者满意度。结果:与V组相比,I组患者术后24 h患肢主动运动VAS评分低、补救性镇痛药物使用剂量少,恶心呕吐发生率低,MMSE评分高,手术结束后开始主动活动时间短,术后镇痛满意度高(P<0.05),患肢肌力评估无显著差异(P>0.05)。结论:超声引导下腹股沟韧带上入路连续髂筋膜间隙阻滞可安全应用于髋关节术后镇痛,术后可提供良好的镇痛效果,显著降低静脉镇痛相关并发症如认知异常等,更利于患者早期主动活动,故此项技术值得在临床推广应用。Objective:To observe the effect of ultrasound-guided supra-inguinal fascia iliaca compartment block as an analgesia technique for the patients undergoing hip arthroplasty.Methods:67 patients undergoing hip arthroplasty surgery was randomly divided into group V(analgesic administered via venous,n=34)and group I(analgesic administered via continuous inguinal fascia iliaca,n=33).24 h postoperative VAS(visual analog scale)of active movement,dose of rescue analgesic(tramadol),ratio of nausea and vomiting,MMSE(mini-mental state examination),time of initiative leg movement after surgery and the ratio of patients with myodynamia over grade 4,patient's satisfaction,all of these were recorded for each group respectively.Results:24 h postoperative VAS of active movement,dose of tramadol and the ratio of nausea and vomiting of the patients in group V were significantly higher than those of group I(P<0.05),while the MMSE score was lower,the time of initiative leg movement after surgery was apparently delayed,and patient's satisfaction with anesthesia was higher than those of group I(P<0.05),there was no significant difference in the ratio of the patients with myodynamia over grade 4 between the two groups(P>0.05).Conclusion:ultrasound-guided supra-inguinal fascia iliaca compartment block as an analgesia technique can provide effective pain management for the hip arthroplasty with less side effects,decrease the use of rescue analgesic and may reduce post cognitive disorder,which is worthy applying in clinical pain management.

关 键 词：超声 神经阻滞 腹股沟韧带 髂筋膜 关节置换 镇痛 

分 类 号：R687.4[医药卫生—骨科学]