超声下布比卡因脂质体股神经阻滞在全膝关节置换术中的应用效果  

Application Effect of Bupivacaine Liposome Femoral Nerve Block under Ultrasound Guided in Total Knee Arthroplasty

作　　者：王宁 宋宁宁 夏姗姗 WANG Ning;SONG Ningning;XIA Shanshan(Department of Anesthesiology,Ganyu District People's Hospital,Lianyungang,Jiangsu,222100,China)

机构地区：[1]江苏省连云港市赣榆区人民医院麻醉科,江苏连云港222100

出　　处：《中外医疗》2025年第4期10-13,共4页China & Foreign Medical Treatment

摘　　要：目的探讨全膝关节置换术中采用超声下布比卡因脂质体进行股神经阻滞的效果。方法随机选取2022年1月—2024年3月江苏省连云港市赣榆区人民医院收治的80例全膝关节置换术患者作为研究对象,根据不同治疗方案将其分为两组,各40例。对照组采用自控静脉连续给予芬太尼作为镇痛方案,观察组采用超声下布比卡因脂质体股神经阻滞。比较两组自控镇痛(patient controlled analgesia,PCA)模式下的首次按压时间、48 h内PCA的按压次数、不同时间(6、12、24、36、48 h)内视觉模拟评分(Visual Analogue Scale,VAS)、不良反应总发生率、镇痛满意度。结果观察组PCA首次按压时间为(78.23±17.52)min,长于对照组的(56.85±18.05)min,差异有统计学意义(t=5.376,P<0.05)。48 h内观察组PCA按压次数为(18.33±0.44)次,少于对照组的(26.60±0.65)次,差异有统计学意义(t=66.636,P<0.05)。术后6 h、12 h、24 h、36 h、48 h,观察组VAS评分均低于对照组,差异有统计学意义(P均<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。观察组镇痛满意度高于对照组,差异有统计学意义(P<0.05)。结论将超声下布比卡因脂质体股神经阻滞技术应用于全膝关节置换术中,可减少PCA按压次数,缓解疼痛,减少不良反应,提高患者镇痛满意度。Objective To investigate the effect of ultrasound guided bupivacaine liposome on femoral nerve block in total knee arthroplasty.Methods A total of 80 patients with total knee arthroplasty admitted to Ganyu District People's Hospital of Lianyungang in Jiangsu from January 2022 to March 2024 were randomly selected as the research objects.According to different treatment schemes,they were divided into two groups,with 40 cases in each group.The control group was treated with self-controlled intravenous continuous administration of fentanyl as an analgesic regimen,and the observation group was treated with ultrasound guided bupivacaine liposome femoral nerve block.The first pressing time under the patient controlled analgesia(PCA)mode,the number of PCA pressing times within 48 h,the visual ana⁃logue scale(VAS)at different times(6,12,24,36,48 h),the total incidence of adverse reactions,and the satisfaction of analgesia were compared between the two groups.Results The first pressing time of PCA in the observation group was(78.23±17.52)min,which was longer than(56.85±18.05)min in the control group,and the difference was statisti⁃cally significant(t=5.376,P<0.05).The number of PCA compressions observed within 48 h was(18.33±0.44)times,which was less than(26.60±0.65)times in the control group,and the difference was statistically significant(t=66.636,P<0.05).At 6 h,12 h,24 h,36 h and 48 h after operation,the VAS score of the observation group was lower than that of the control group,and the differences were statistically significant(all P<0.05).The total incidence of adverse reac⁃tions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The analgesia satisfaction the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of ultrasoundguided bupivacaine liposome femoral nerve block technique in total knee arthroplasty can reduce the number of PCA pressing,reliev

关 键 词：布比卡因脂质体 超声 股神经阻滞 全膝关节置换术 疼痛 

分 类 号：R614[医药卫生—麻醉学]