硬膜外吗啡复合腰骶丛神经阻滞镇痛对老年髋关节置换术后康复质量的影响  

Effect of Epidural Morphine Combined with Lumbosacral Plexus Block on the Rehabilitation Quality in Elderly Patients Undergoing Hip Joint Replacement

作　　者：康鹏 Kang Peng(The first People's Hospital of Xiangcheng City,Zoukou Henan 466000)

机构地区：[1]项城市第一人民医院,河南周口466000

出　　处：《辽宁医学杂志》2022年第4期98-101,共4页Medical Journal of Liaoning

摘　　要：目的 探讨硬膜外吗啡复合腰骶丛神经阻滞镇痛对老年髋关节置换术后康复质量的影响。方法 选取2018年2月至2020年3月到我院行髋关节置换术患者74例作为研究对象,按照不同镇痛方式随机分为硬膜外吗啡镇痛组22例,腰骶丛神经阻滞组24例与联合组(硬膜外吗啡复合腰骶丛神经阻滞)28例。记录术后4、6、8、12、24、36及48h采用VAS评价疼痛强度,包括静息VAS评分和运动VAS评分,测量并记录24、36、48及72h患者髋关节的最大屈曲和外展活动度与术后6h站立与术后第1日晨行走情况及不良反应。结果 联合组在术后4h、6h、8h、24h、36h、48h运动VAS评分显著优于硬膜外吗啡镇痛组与腰骶丛神经阻滞组(P<0.05);术后联合组24h、36h、48h与72h髋关节最大屈曲度与最大外展度优于硬膜外吗啡镇痛组与腰骶丛神经阻滞组(P<0.05);联合组术后6h站立与术后第1日晨行走显著优于硬膜外吗啡镇痛组与腰骶丛神经阻滞组(P<0.05);联合组不良反应低于硬膜外吗啡镇痛组与腰骶丛神经阻滞组;硬膜外吗啡镇痛组不良反应显著高于联合组与腰骶丛神经阻滞组(P<0.05)。结论 老年采取髋关节置换术患者,采取硬膜外吗啡复合腰骶丛神经阻滞可达到满意的镇痛性,且无较大的副反应。Objective To investigate effect of epidural Morphine combined with lumbosacral plexus block on the rehabilitation quality in elderly patients undergoing hip joint replacement.Methods 74 patients underwent hip joint replacement in our hospital from January 2018 to March 2020 were selected and divided into three groups according to different analgesic methods,namely,epidural Morphine group(n=22),lumbosacral plexus block group(n=24),and combined group(n=28).Ambulatory VAS scores and resting VAS scores at the postoperative 4 h,6 h,8 h,12 h,24 h,36 h,and 48 h,maximal hip flexion and abduction ranges of motion at the postoperative 24 h,36 h,and 48 h,standing ability at the postoperative 6 h,and motor activity at the postoperative 1 d,as well as the adverse reactions of two groups were recorded.Results Ambulatory VAS scores at the postoperative 4 h,6 h,8 h,24 h,36 h,and 48 h of the combined group were higher than those of the other two groups(P<0.05).The maximal hip flexion and abduction ranges of motion at the postoperative 24 h,36 h,and 48 h of the combined group were better than those of the other two groups(P<0.05).The standing ability at the postoperative 6 h,and motor activity at the postoperative 1 d of the combined group were better than those of the other two groups(P<0.05).The incidence rate of the adverse reactions among three groups ranked in a descending order was epidural Morphine group,lumbosacral plexus block group and combined group(P<0.05).Conclusion The analgesic effect of epidural Morphine combined with lumbosacral plexus block in elderly patients undergoing hip joint replacement is preferable,which has less adverse reaction.

关 键 词：髋关节置换 吗啡 腰骶丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]