纳布啡复合罗哌卡因用于髂筋膜间隙阻滞对老年髋部骨折病人术前镇痛效果的影响  

Efficacy of Nalbuphine as an Adjuvant to ropivacaine in fascial iliac compartment block for preoperative analgesia in elderly patients with hip fracture

作　　者：黄风怡[1] 陈一佳 高飞[1] 谢冰心 罗玉蓉 郑艇[1] 郑晓春[1,2,3] HUANG Fengyi;CHEN Yijia;GAO Fei(Department of Anesthesiology,Fujian Provincial Hospital,Provincial Clinical Medical College,Fujian Medical University,Fujian Provincial,Fuzhou 350001,China;不详)

机构地区：[1]福建省立医院麻醉科,350001 [2]福建省急救中心 [3]福建省急诊医学研究所

出　　处：《临床外科杂志》2022年第6期524-527,共4页Journal of Clinical Surgery

基　　金：福建省科技创新联合资金项目(2019Y9028);福建省医学创新课题(2020CXB002);福建医科大学教育教学改革研究项目(J19018);福建医科大学启航基金(2018QH1128)。

摘　　要：目的 探讨纳布啡复合罗哌卡因行髂筋膜间隙阻滞对老年髋部骨折病人术前镇痛效果的影响。方法 选取我院2020年3月1日~2020年12月1日行髋部骨折(股骨颈骨折、股骨粗隆间骨折)手术治疗的老年病人70例,采用随机数字表法分为单纯罗哌卡因组(L组)和纳布啡复合罗哌卡因组(N组)两组,每组各35例。L组:0.1%罗哌卡因30 ml+0.9%盐水2 ml;N组:0.1%罗哌卡因30 ml+纳布啡20 mg。入院后均采用腹股沟韧带下入路法行髂筋膜间隙阻滞进行术前镇痛。记录镇痛持续时间,阻滞后30分钟、2小时、6小时、8小时的感觉阻滞面积;记录夜间睡眠被疼痛干扰的次数,阻滞后并发症及住院时间。结果 N组和L组镇痛持续时间分别为(9.250±0.465)小时和(6.143±0.851)小时,夜间睡眠被疼痛干扰次数分别为0(0,0)次和0(0,2)次,两组比较差异有统计学意义(P<0.05);两组并发症恶心分别为0和5.88%,呕吐分别为0和2.94%,神经并发症分别为0和0,术前住院时间分别为3(2,4)天和3(2,4)天,术后住院时间分别为7(7,9)天和8(7,9)天,两组比较,差异无统计学意义(P>0.05)。结论 纳布啡复合罗哌卡因用于术前髂筋膜间隙阻滞可延长其镇痛持续时间。Objective To evaluate the effect of nalbuphine used as an adjuvant to ropivacaine during FICB on the duration of preoperative analgesia in patients with hip fracture.Methods eventy elderly patients with hip fracture(femoral neck fracture and intertrochanteric fracture) were selected from Our hospital from March 1,2020 to December 1,2020.Random number table method was used to divide them into two groups: ropivacaine group(group L) and nalbuphine combined with ropivacaine group(group N)(n=35 in each).All of the patients received fascia iliaca block inferior to the inguinal ligament soon after admission.Patients in group L received a local anesthetic of 30 ml of 0.1% ropivacaine and 2 ml of saline while those in group N used local 30 ml of 0.1% ropivacaine and 20 mg of nalbuphine.The primary outcome measure was the duration of analgesia.Secondary outcomes included sensory block area at 30 min, 2 h, 6 h, and 8 h after block, the number of sleep disturbances by pain, side effects, and the length of stay.Results Compared with group L,the duration of analgesia was significantly prolonged[(9.250±0.465)h vs(6.143±0.851)h, P<0.05],the times of sleep disturbances by pain was lower in group N[0(0,0) vs 0(0,2),P<0.05].There was no difference in the incidence of side effects(0 vs 5.88% for nausea, 0 vs 2.94% for vomiting, 0 vs 0 for neurological complications, all P>0.05) and llength of stay before surgery[3(2,4) days vs 3(2,4) days for preoperative hospital stay, 7(7,9) days vs 8(7,9)days for postoperative hospital stay, both P>0.05].Conclusion Nalbuphine can prolong the duration of analgesia when it was used as an adjuvant to ropivacaine during FICB in patients with hip fractures.

关 键 词：纳布啡 罗哌卡因 髂筋膜间隙阻滞 髋部骨折 术前镇痛 

分 类 号：R614[医药卫生—麻醉学]