可视化超声引导下髂筋膜加坐骨神经阻滞在髋部手术麻醉的临床研究  

Visual Ultrasound Guided Iliac Fascia Plus Sciatic Nerve Block in Hip Surgery Anesthesia Clinical Research

作　　者：李莉 李雪兰 阮沛生 程平瑞 LI li;LI Xue-lan;RUAN Pei-sheng;CHENG Ping-rui(Department of Anesthesiology,Panyu Central Hospital,Guangzhou,511400;Department of Anesthesiology,Guangzhou Panyu Central Hospital)

机构地区：[1]广东省广州市番禺中心医院麻醉科,511400

出　　处：《岭南急诊医学杂志》2025年第1期25-27,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨可视化超声引导髂筋膜间隙阻滞加坐骨神经阻滞在髋部手术中的应用。方法:选取本院2021年6月至2023年5月接诊的88例老年髋部手术患者,排除不符合入选标准的6例,不同意10例,随机双盲法分成A、B两组,A组(n=36)给予超声引导髂筋膜间隙阻滞加坐骨神经阻滞,B组(n=36)行腰硬联合麻醉,观察两组血流动力学、麻醉镇痛持续时间、术后VAS疼痛评分、术后恶心呕吐、头晕等不良反应。结果:A、B两组间一般情况和麻醉前平均动脉压、心率相比无差异;A组麻醉作用时间长于B组,差异有统计学意义。两组在T2、T3时点,MAP、HR差异有统计学意义。A组低血压、呕吐、头晕发生率相比更低。结论:可视化超声引导髂筋膜腔隙阻滞加坐骨神经阻滞在髋部手术中麻醉效果优,镇痛效果佳,减少术后不良反应的发生率。Objective:To investigate the effect of visual ultrasound guided iliac fascia plus sciatic nerve block in hip operation anesthesia.Methods:A total of 88 elderly patients receiving hip surgery in our hospital from June 2021 to May 2023 were selected,6 cases that did not meet the inclusion criteria were excluded,and 10 cases that did not agree were randomly divided into two groups,group A(n=36)was given ultrasound‐guided iliac fascia space block plus sciatic nerve block,group B(n=36)was given combined lumbar and epidural anesthesia.Hemodynamics,duration of anesthesia and analgesia,VAS score after anesthesia were observed.The adverse reactions such as nausea,vomiting and dizziness were observed.Results:At T2 and T3 time points,MAP and HR are different before anesthesia between groups A and B;The duration of anesthesia in group A was longer than that in group B,and the difference was statistically significant.There were significant differences in MAP and HR between the two groups at T2 and T3 time points.The incidence of hypotension,vomiting and dizziness in group A was lower than that in Group A.Conclusion:Visual ultrasound guided iliofascial lacunar block+sciatic nerve block has excellent anesthetic effect in hip surgery,precise analgesia promotes early activity of patients,reduces the incidence of postoperative adverse reactions.

关 键 词：髋部手术 可视化超声引导 髂筋膜腔隙阻滞 坐骨神经阻滞 

分 类 号：R614[医药卫生—麻醉学]