超声引导下神经阻滞联合切口皮肤注射鸡尾酒式药物在全髋关节置换术后镇痛的应用研究  

Application of Ultrasound-guided Nerve Block Combined with Incision Skin Injection of Cocktail Drug in Postoperative Analgesia after Total Hip Arthroplasty

作　　者：周峰[1] 何杰 杨顺 马林[1] 赵宇新[1] 王华杰 姜红波 丁桂凤 ZHOU Feng;HE Jie;YANG Shun;MALin;ZHAO Yuxin;WANG Huajie;JIANG Hongbo;DING Guifeng(Jiangyan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Taizhou 225500,China;不详)

机构地区：[1]南京中医药大学附属姜堰中医院,江苏泰州225500

出　　处：《中国医学创新》2023年第25期143-146,共4页Medical Innovation of China

基　　金：泰州市科技支撑计划(社会发展)项目指令性计划项目(TS202016)。

摘　　要：目的:研究分析超声引导下神经阻滞联合切口皮肤注射鸡尾酒式药物在后外侧入路全髋关节置换术后的效果。方法:将2019年10月—2021年10月南京中医药大学附属姜堰中医院收治的120例股骨颈骨折患者随机分为A组(n=60,予以髂筋膜+骶丛神经阻滞+切口皮肤注射鸡尾酒式药物)和B组(n=60,予以髂筋膜+骶丛神经阻滞)。比较两组全髋关节置换术后6、12、18、24 h及3、7 d时的视觉模拟评分法(VAS)评分及术后止痛药物使用量。结果:术后6、12 h,两组静息状态下VAS评分及止痛药物使用量比较,差异均无统计学意义(P>0.05);术后18、24 h静息状态下及术后3、7 d下地行走时的VAS评分比较,A组均低于B组(P<0.05);术后18、24 h及3、7 d止痛药物使用量比较,A组均少于B组(P<0.05)。结论:超声引导下神经阻滞联合切口皮肤注射鸡尾酒式药物能有效减轻患者术后疼痛,减少术后止痛药物使用量。Objective:To study and analyze the effect of ultrasound-guided nerve block combined with incised skin injection of cocktail drug after posterior lateral approach total hip arthroplasty.Method:A total of 120 patients with femoral neck fracture admitted to Jiangyan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from October 2019 to October 2021 were randomly divided into A group(n=60,iliac fascia+sacral plexus nerve block+incised skin injection cocktail)and B group(n=60,iliac fascia+sacral plexus nerve block).Visual analogue scale(VAS)scores and dosage of postoperative analgesic drug were compared between the two groups at 6,12,18,24 h and 3,7 d after total hip arthroplasty.Result:At 6 and 12 h after surgery,there were no significant differences in VAS scores in resting state and dosage of analgesic drug between the two groups(P>0.05).The VAS scores of A group were lower than those of B group at 18 and 24 h in resting state and at 3 and 7 d when walking on the ground after surgery(P<0.05).The dosage of analgesic drug in A group were lower than those in B group at 18,24 h and 3,7 d after surgery(P<0.05).Conclusion:Ultrasound-guided nerve block combined with incised skin injection of cocktail drug can effectively reduce postoperative pain and reduce the dosage of postoperative analgesic drug.

关 键 词：全髋关节置换术 视觉模拟评分法 神经阻滞 股骨颈骨折 鸡尾酒 

分 类 号：R687.4[医药卫生—骨科学]