超声引导腹股沟韧带上髂筋膜阻滞对髋关节骨折术补救镇痛次数及血管活性药物使用次数的影响  

The Effect of Ultrasound-Guided Iliac Fascia Block Above the Inguinal Ligament on the Number of Rescue Analgesia and the Use of Vasoactive Drugs in Hip Fracture Surgery

作　　者：夏新 桂诚 王雪莹 XIA Xin;GUI Cheng;WANG Xueying(Department of Anesthesiology,Zhenjiang 359 Hospital,Zhenjiang,Jiangsu 212001,China)

机构地区：[1]镇江三五九医院麻醉科,江苏镇江212001

出　　处：《中国医药指南》2025年第2期28-31,共4页Guide of China Medicine

摘　　要：目的探索超声引导腹股沟韧带上髂筋膜阻滞对髋关节骨折术补救镇痛次数及血管活性药物使用次数的影响。方法选取2023年1月至2024年7月江苏省镇江市三五九医院骨科81例髋关节骨折患者,利用随机数表法分为对照组(40例)和试验组(41例)。两组均接受除术中麻醉手段外相同的手术方案,其中,对照组采用腰硬联合麻醉,试验组在对照组基础上增加超声引导下腹股沟韧带上髂筋膜间隙阻滞。比较两组患者的补救镇痛次数、血管活性药物使用次数、VAS评分、心率、平均动脉压、首次下床时间、术后开始主动活动时间、住院时间及各时刻神经阻滞率。结果试验组在第1次补救镇痛时间、补救镇痛次数、血管活性药物使用次数方面均优于对照组(P<0.05)。试验组与对照组在术后6 h、12 h、24 h、48 h的VAS评分无差异(P>0.05)。在切皮、击打假体和术毕时,试验组的心率和平均动脉压均低于对照组(P<0.05)。试验组首次下床时间早于对照组(P<0.05),术后开始主动活动时间长于对照组(P<0.05),但术后住院时间与对照组比较无差异(P>0.05)。试验组ON和LFCN的阻滞率高于对照组(P<0.05),但在FN阻滞率上,组间无差异(P>0.05)。结论超声引导腹股沟韧带上髂筋膜阻滞可降低髋关节骨折术补救镇痛次数及血管活性药物使用次数,减少术后并发症的发生。Objective To explore the effect of ultrasound-guided iliac fascia block above the inguinal ligament on the number of rescue analgesia and the use of vasoactive drugs in hip fracture surgery.Methods A total of 81 patients with hip fractures from January 2023 to July 2024 in our hospital were randomly divided into a control group(40 cases)and a trial group(41 cases)using random number table method.Both groups received the same surgical plan except for intraoperative anesthesia methods.The control group underwent combined spinal-epidural anesthesia,while the trial group received additional ultrasound-guided iliac fascia space block above the inguinal ligament on the basis of the control group.The number of rescue analgesia,the use of vasoactive drugs,VAS scores,heart rate,mean arterial pressure,time to first ambulation,time to start active postoperative activities,and hospital stay were compared between the two groups.Results The trial group was superior to the control group in terms of the first rescue analgesia time,the number of rescue analgesia,and the use of vasoactive drugs(P<0.05).There was no difference in VAS scores between the trial group and the control group at 6 hours,12 hours,24 hours,and 48 hours post-surgery(P>0.05).At the time of skin incision,prosthesis impact,and at the end of surgery,the HR and MAP of the trial group were lower than those of the control group(P<0.05).The time to first ambulation in the trial group was faster than that in the control group(P<0.05),and the time to start active postoperative activities was longer than that in the control group(P<0.05),but there was no difference in postoperative hospital stay between the two groups(P>0.05).The blockage rate of ON and LFCN in the trial group was higher than that in the control group(P<0.05),but there was no difference in the blockage rate of FN between the groups(P>0.05).Conclusions Ultrasound-guided iliac fascia block above the inguinal ligament can reduce the number of rescue analgesia and the use of vasoactive drugs in hip fractur

关 键 词：超声引导 腹股沟韧带 上髂筋膜阻滞 髋关节骨折术 补救镇痛 血管活性药物 

分 类 号：R683[医药卫生—骨科学]