超声引导下臀上神经阻滞联合髂筋膜间隙阻滞在老年人工股骨头置换术患者中的应用效果  

Application effect of superior gluteal nerve block combined with fascia iliac compartment block under the guidance of ultrasound for artificial femoral head replacement in elderly patients

作　　者：陈亚迟 柯雅真 徐文娟 林艺勇 CHEN Yachi;KE Yazhen;XU Wenjuan;LIN Yiyong(The Second Affiliated Hospital of Xiamen Medical College,Fujian Province,Xiamen 361021,China)

机构地区：[1]厦门医学院附属第二医院,福建省厦门市361021

出　　处：《临床合理用药杂志》2023年第27期31-34,38,共5页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察超声引导下臀上神经阻滞(SGNB)联合髂筋膜间隙阻滞(FICB)在老年人工股骨头置换术患者中的应用效果。方法选取2021年7月-2022年6月于厦门医学院附属第二医院行人工股骨头置换术的老年骨折患者40例,采用随机数字表法分为SGNB+FICB组和腰麻组,各20例。SGNB+FICB组患者在超声引导下行SGNB联合FICB麻醉,腰麻组患者行腰部麻醉,其他处理一致。比较2组术前及术后6、24 h视觉模拟评分法(VAS)评分、Ramsay镇静评分,麻醉诱导前(T_(0))、手术开始即刻(T_(1))、术后5 min(T_(2))、术后10 min(T_(3))、扩髓腔即刻(T_(4))的收缩压(SBP)、舒张压(DBP)及心率(HR),手术时长、麻醉后恢复室(PACU)入住时长、麻醉操作时长、镇痛泵按压次数及麻黄碱、舒芬太尼使用率。结果SGNB+FICB组术后6、24 h VAS评分低于腰麻组,Ramsay镇静评分高于腰麻组(P<0.05)。2组T_(1)、T_(2)、T_(3)、T_(4)的SBP、DBP、HR低于T_(0),而SGNB+FICB组T_(1)、T_(2)、T_(3)、T_(4)的SBP、DBP均高于腰麻组(P<0.05),但2组不同时点的HR比较,差异无统计学意义(P>0.05)。SGNB+FICB组麻醉操作时长短于腰麻组,镇痛泵按压次数少于腰麻组(P<0.01),但2组手术时长、PACU入住时长及麻黄碱、舒芬太尼使用率比较,差异无统计学意义(P>0.05)。结论SGNB联合FICB对老年人工股骨头置换术患者的麻醉效果优于腰部麻醉,其可缩短操作时间,维持机体血流动力学稳定,且可延长术后镇痛镇静持续时间。Objective To observe the application effect of SGNB combined with FICB under the guidance of ultrasound for artificial femoral head replacement in elderly patients.Methods Forty cases of elderly patients with artificial femoral head replacement were selected from July 2021 to June 2022 in the Second Affiliated Hospital of Xiamen Medical College,they were divided into the SGNB+FICB group with 20 cases and the spinal anesthesia group with 20 cases.Patients in the SGNB+FICB group were given SGNB combined with FICB anesthesia under the guidance of ultrasound,and patients in the spinal anesthesia group were given spinal anesthesia,the other treatments were consistent.VAS score,Ramsay score before operation and at 6,24 hours after operation,SBP,DBP,HR before anesthesia induction(T_(0)),immediately after the operation(T_(1)),at 5 min after operation(T_(2)),at 10 min after operation(T_(3)),immediate reaming cavity(T_(4)),operation duration,PACU duration,duration of anesthesia operation,analgesic pump pressing times and utilization rate of ephedrine and sufentanil were compared between the two groups.Results SGNB+FICB group of VAS score at 6,24 hours after operation were lower than those of the spinal anesthesia group,and Ramsay score at 6,24 hours after operation were higher than thsoe of the spinal anesthesia group(P<0.05).SBP,DBP,HR at T_(1),T_(2),T_(3),T_(4)of the two groups were lower than those of T_(0),and SBP,DBP at T_(1),T_(2),T_(3),T_(4)of the SGNB+FICB group were higher than those of the spinal anesthesia group(P<0.05),there was no significant difference of HR at different points between the two groups(P>0.05).Duration of anesthesia operation of the SGNB+FICB group was shorter than that of the spinal anesthesia group,analgesic pump pressing times was less than that of the spinal anesthesia group(P<0.01),there was no significant difference of operation duration,PACU duration or utilization rate of ephedrine and sufentanil between the two groups(P>0.05).Conclusion The anesthetic effect of SGNB combined with FICB

关 键 词：人工股骨头置换术 老年人 髂筋膜间隙阻滞 臀上神经阻滞 超声引导 腰部麻醉 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]