超声引导髂腹下/髂腹股沟神经阻滞用于老年患者选择性激光前列腺汽化术术后镇痛效果观察  

Analgesic effect of ultrasound-guided iliohypogastric/ilioinguinal nerve block in elderly patients after prostate vaporectomy

作　　者：后晓超[1] 钮峥嵘[1] 吴新华[1] 徐桂萍[1] Hou Xiaochao;Niu Zhengrong;Wu Xinhua;Xu Guiping(Department of Anesthesiology,People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Clinical Research Center for Anesthesia Management,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院麻醉科,新疆麻醉管理临床医学研究中心,乌鲁木齐830001

出　　处：《国际麻醉学与复苏杂志》2023年第3期269-272,共4页International Journal of Anesthesiology and Resuscitation

基　　金：新疆维吾尔自治区重点研发任务专项(2022B03009-4)。

摘　　要：目的观察超声引导下髂腹下/髂腹股沟神经(iliohypogastric/ilioinguinal nerve,IIIHN)阻滞用于老年患者选择性激光前列腺汽化术(photoselective laser vaporization of prostate,PVP)术后镇痛效果。方法选取2022年1月至2022年5月在新疆维吾尔自治区人民医院择期行PVP的患者58例,年龄65~80岁,ASA分级Ⅱ、Ⅲ级。采用随机数字表法将患者分为2组,IIIHN阻滞联合全麻组(I组,28例)和单纯全麻组(G组,30例)。I组患者于全身麻醉前行超声引导双侧IIIHN阻滞,每侧注入0.5%罗哌卡因0.25 ml/kg;G组仅行全身麻醉。记录术中丙泊酚用量、术中瑞芬太尼用量、术后酮咯酸氨丁三醇补救镇痛例数,术后1、6、12、24 h患者静息和运动VAS疼痛评分,术后恶心呕吐、眩晕、嗜睡、瘙痒等不良反应及区域阻滞相关并发症发生情况。结果I组患者术后1、6、12、24 h静息及运动VAS疼痛评分均低于G组(P<0.05)。两组患者一般情况、手术时间、术中出血量、丙泊酚用量、瑞芬太尼用量、术后酮咯酸氨丁三醇补救镇痛例数、术后不良反应发生率差异均无统计学意义(P>0.05)。两组患者均未出现区域阻滞相关并发症。结论超声引导IIIHN阻滞可安全、有效地用于老年患者PVP术后镇痛,可以缓解患者早期静息、运动状态疼痛,有利于患者加速康复。Objective To observe the analgesic effect of ultrasound-guided iliohypogastric/ilioinguinal nerve(IIIHN)block in elderly patients after photoselective laser vaporization of prostate(PVP).Methods A total of 58 patients,aged 65−80 years old,American Society of Anesthesiologists(ASA)Ⅱ−Ⅲgrade,who underwent PVP surgery in People's Hospital of Xinjiang Uygur Autono-mous Region from January 2022 to May 2022 were selected.According to the random number table method,they were divided into two groups:a IIIHN block combined with general anesthesia group(group I,n=28)and a general anesthesia alone group(group G,n=30).Patients in group I underwent ultrasound-guided bilateral IIIHN block before general anesthesia,and each side was injected with a con-centration of 0.5%ropivacaine at a dose of 0.25 ml/kg.Group G received general anesthesia alone.The intraoperative dosages of propo-fol and remifentanil,and the postoperative dosages of ketorolac tromethamine for rescue analgesia were recorded.The Visual Analogue Scale(VAS)scores were recorded at rest and during exercises at postoperative 1,6,12 h and 24 h.Postoperative adverse reactions such as nausea,vomiting,vertigo,drowsiness,pruritus,and complications related to regional block were recorded.Results The VAS scores at rest and during exercise at postoperative 1,6,12 h and 24 h in group I were lower than those in group G(P<0.05).There were no significant differences in general information,operation time,intraoperative blood loss,propofol dosage,remifentanil dosage,the use of ketorolac tromethamine for rescue analgesia after surgery,and yje incidence of postoperative adverse reactions between the two groups(P>0.05).No complications related to regional block were found in both group.Conclusions Ultrasound-guided IIIHN block is safe and effective for postoperative analgesia in elderly patients after PVP,which can relieve patients'early pain at rest and during exercise and accelerate their recovery.

关 键 词：髂腹下神经 髂腹股沟神经 神经阻滞 选择性激光前列腺汽化术 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]