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作 者:郭朝剑 胡炜 徐敏 赵岚 孟海兵 李浩 双峰 GUO Chaojian;HU Wei;XU Min;ZHAO Lan;MENG Haibing;LI Hao;SHUANG Feng(Department of Orthopedic Surgery,the 908th Hospital of the Joint Logistics Support Force of PLA,Nanchang,Jiangxi 330002,China;不详)
机构地区:[1]联勤保障部队第九〇八医院骨科,江西南昌330002 [2]联勤保障部队第九〇八医院麻醉科,江西南昌330002
出 处:《中国临床研究》2024年第8期1202-1205,共4页Chinese Journal of Clinical Research
基 金:江西省卫生健康委科技计划(202211373,202311384);2022年院级苗子基金项目(2022YNKT011)。
摘 要:目的 比较超声引导下股神经阻滞和口服塞来昔布在老年髋部骨折术前镇痛中的疗效。方法 选择2019年1月至2022年6月联勤保障部队第九八医院收治的老年髋部骨折手术患者68例,采用随机数字表法分为试验组和对照组,各34例。试验组在超声引导下用0.3%罗哌卡因20 mL阻滞股神经;对照组口服塞来昔布胶囊(0.2 g,每天2次)。比较两组实施干预前10 min、干预后30 min、干预后2 h、手术前10 min的视觉模拟评分(VAS),记录治疗后恶心呕吐、头晕、药物不良反应等并发症。结果 两组患者干预前VAS评分比较差异无统计学意义(P>0.05)。试验组随着治疗时间的推移,VAS评分逐渐降低(P<0.05)。对照组治疗后各时间点VAS评分低于治疗前,术前10 min的VAS评分(3.85±1.11)较干预后2 h升高(3.24±1.02);试验组治疗后各个时间点VAS评分均低于对照组(P<0.05)。试验组不良反应发生率低于对照组(17.6%vs 41.2%,χ^(2)=4.53,P<0.05)。结论 超声引导下股神经阻滞和口服塞来昔布药物均能减轻老年髋部骨折患者术前疼痛,但前者治疗更安全,并可以持续减轻疼痛。Objective To compare the efficacy of ultrasound-guided femoral nerve block and oral celecoxib for preoperative analgesia in elderly patients with hip fractures.Methods Sixty-eight elderly patients with hip fracture surgery treated at the 908th Hospital of Joint Logistics Support Force from January 2019 to June 2022 were selected and randomly divided into two groups:the experimental group(femoral nerve block)and the control group(oral celecoxib),with 34 cases in each group.The experimental group received a 20 mL 0.3%ropivacaine for femoral nerve block under ultrasound guidance,while the control group was given celecoxib capsules(0.2 g,twice daily).Visual analog scores(VAS)were compared between the two groups at 10 minutes before intervention,30 minutes after intervention,2 hours after intervention,and 10 minutes before surgery.Complications such as nausea,vomiting,dizziness,and adverse drug reactions were also recorded.Results There was no significant difference in VAS scores between the two groups before intervention(P>0.05).In the experimental group,VAS scores gradually decreased over time(P<0.05).In the control group,VAS scores at each time point after intervention were lower than before intervention,with a higher score 10 minutes before surgery(3.85±1.11)compared to 2 hours after intervention(3.24±1.02).The experimental group had lower VAS scores at all time points after intervention compared to the control group(P<0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group(17.6%vs 41.2%,χ^(2)=4.53,P<0.05).Conclusion Both ultrasound-guided femoral nerve block and oral celecoxib can alleviate preoperative pain in elderly patients with hip fractures,but ultrasound-guided femoral nerve block is safer and can sustain pain relief.
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