超声引导下髂筋膜间隙阻滞对老年股骨近端骨折的镇痛效果及对其血流动力学的影响  

The Analgesic Effect of Ultrasound-guided Iliac Fascial Space Block on Elderly Proximal Femoral Fractures and Its Hemodynamics

作　　者：颜凤凤[1] 程芳杨 爱兴 刘静 YAN Fengfeng;CHENG Fangyang;AI Xing;LIU Jing(Department of Anesthesiology,Dongfang Hospital,Lianyungang,Jiangsu Province,222042 China)

机构地区：[1]江苏省连云港市东方医院麻醉科,江苏连云港222042

出　　处：《系统医学》2021年第24期57-60,共4页Systems Medicine

摘　　要：目的分析股骨近端骨折老年患者实施超声引导下髂筋膜间隙阻滞的镇痛效果及对血流动力学的作用。方法选取2020年4月—2021年6月在该院接受手术治疗的股骨近端骨折老年患者60例,以随机数表法分为观察组(30例)与对照组(30例)。对照组实施全麻,观察组实施超声引导下髂筋膜间隙阻滞麻醉,对比麻醉效果,监测记录两组患者麻醉后不同时间血流动力学水平变化,统计两组患者出现不良反应总发生率。结果观察组患者麻醉苏醒时间(9.45±1.14)min、拔管时间(12.13±2.02)min均明显短于对照组,且丙泊酚用量(409.45±23.19)mg低于对照组,差异有统计学意义(t=19.889、13.063、22.615,P<0.05)。气管插管时、手术开始5 min后及手术完成后观察组患者平均动脉压均明显高于对照组,心率低于对照组,波动幅度小于对照组,差异有统计学意义(P<0.05)。另外,观察组患者不良反应总发生率3.33%低于对照组,差异有统计学意义(χ^(2)=4.706,P<0.05)。结论股骨近端骨折老年患者接受手术治疗期间配合超声引导下髂筋膜间隙阻滞麻醉具有镇痛效果好,安全性高等优点,对患者血流动力学影响小,提倡运用推广。Objective To analyze the analgesic effect and hemodynamic effects of ultrasound-guided iliac fascia block in elderly patients with proximal femoral fractures. Methods From April 2020 to June 2021, selected 60 elderly patients with proximal femoral fractures undergoing surgical treatment in the hospital. The random number table was divided into observation group(30 cases) and control group(30 cases). The control group was given general anesthesia,and the observation group was given ultrasound-guided block anesthesia of the iliac fascial space. The effects of anesthesia were compared, and the changes in hemodynamic levels of the two groups of patients at different times after anesthesia were monitored and recorded. Statistics of the total incidence of adverse reactions in the two groups of patients. Results The time to wake up from anesthesia(9.45±1.14) min and the time to extubation(12.13±2.02) min in the observation group were significantly shorter than those in the control group and the dosage of propofol(409.45 ±23.19) mg was lower than the control group, the difference was statistically significant(t=19.889, 13.063, 22.615, P<0.05). The average arterial pressure of patients in the observation group was significantly higher than that in the control group after tracheal intubation, 5 min after the start of the operation, and after the completion of the operation.The heart rate was lower than that of the control group,and the fluctuation range was smaller than that of the control group. The difference was statistically significant(P<0.05). In addition, the total incidence of adverse reactions in the observation group was 3.33% lower than that in the control group, and the difference was statistically significant(χ^(2)=4.706, P <0.05). Conclusion During the surgical treatment of elderly patients with proximal femoral fractures, ultrasound-guided iliac fascial block anesthesia has the advantages of good analgesia, high safety, and small impact on the hemodynamics of patients. It is recommended to promote the ap

关 键 词：超声 髂筋膜间隙阻滞 老年 股骨近端骨折 镇痛效果 血流动力学 

分 类 号：R68[医药卫生—骨科学]