不同神经阻滞技术对全髋关节置换术患者术后镇痛效果及髋部运动的影响比较  

Comparison of the Effects of Different Nerve Block Techniques on Postoperative Analgesic Effect and Hip Movement in Patients Undergoing Total Hip Arthroplasty

作　　者：安鲁毅 叶秀丽 阮惠娟 AN Luyi;YE Xiuli;RUAN Huijuan(不详;Department of Anesthesia,Fuzhou First General Hospital,Fuzhou 350009,China)

机构地区：[1]福州市第一总医院麻醉科,福建福州350009

出　　处：《中国医学创新》2024年第21期144-148,共5页Medical Innovation of China

摘　　要：目的:探讨髂腰肌平面阻滞(IPB)与髂筋膜间隙阻滞(FICB)对全髋关节置换术(THA)患者术后镇痛效果及髋部运动的影响。方法:将2022年1月—2023年12月在福州市第一总医院行THA的96例患者随机分为对照组与观察组,每组48例。麻醉诱导前,对照组行FICB,观察组行IPB,两组术后均予以静脉镇痛。记录两组神经阻滞操作时间和术中麻醉药物使用情况;于术后2、6、12和24 h,对患者疼痛评分分别进行记录;对两组术后24 h内镇痛情况进行记录;记录两组患者术后24 h内股四头肌肌无力发生情况;此外,记录两组术后恢复情况。结果:较于对照组,观察组神经阻滞操作时间更短(P<0.05),两组术中丙泊酚和瑞芬太尼用量差异均无统计学意义(P>0.05)。两组术后2、6、12和24 h各时间点疼痛评分、术后24 h内镇痛泵按压次数、舒芬太尼用量及补救镇痛率对比差异均无统计学意义(P>0.05)。较于对照组,观察组术后股四头肌肌无力发生率显著下降,且术后首次下床活动时间提前,术后住院时间缩短,差异均有统计学意义(P<0.05)。结论:IPB应用于THA可为患者提供良好的镇痛效果,且相比FICB,对髋部运动能力无不良影响,有利于术后快速恢复。Objective:To explore the effects of iliopsoas plane block(IPB)and fascia iliaca compartment block(FICB)on the postoperative analgesic effect and hip movement of patients undergoing total hip arthroplasty(THA).Method:A total of 96 patients who underwent THA in Fuzhou First General Hospital from January 2022 to December 2023 were randomly divided into control group and observation group,with 48 cases in each group.Before anesthesia induction,the control group underwent FICB and the observation group underwent IPB,and both groups were given intravenous analgesia after surgery.The operation time of nerve block and the use of anesthetic drugs during surgery for both groups were recorded;the pain scores of patients at 2,6,12 and 24 hours after surgery were recorded;the analgesic situation within 24 hours after surgery for both groups were recorded;the occurrence of quadriceps femoris weakness within 24 hours after surgery for both groups were recorded;in addition,the postoperative recovery situation of both groups were recorded.Result:Compared with the control group,the operation time of nerve block in the observation group was shorter(P<0.05),and there were no statistical differences in the dosages of Propofol and Remifentanil during surgery between the two groups(P>0.05).There were no statistical differences in the pain scores at 2,6,12,and 24 hours after surgery,the number of analgesic pump compressions within 24 hours after surgery,the dosage of Sufentanil and the rate of remedial analgesia between the two groups(P>0.05).Compared with the control group,the incidence of quadriceps femoris muscle weakness after surgery in the observation group decreased significantly,and the time of the first getting out of bed after surgery was advanced,and the postoperative hospital stay was shortened,the differences were statistical significance(P<0.05).Conclusion:The application of IPB in THA can provide good analgesic effect for patients,and compared to FICB,it has no adverse effects on hip mobility,which is beneficial for rapid

关 键 词：全髋关节置换术 髂腰肌平面阻滞 髂筋膜间隙阻滞 镇痛 髋部运动 

分 类 号：R614[医药卫生—麻醉学]