超声引导下髂筋膜间隙阻滞联合轻比重罗哌卡因单侧腰部麻醉在老年髋部骨折患者围手术期镇痛中的效果研究  

Research on the Effect of Ultrasound-Guided Fascia Iliaca Compartment Block Combined with Unilateral Lumbar Anesthesia with Hypobaric Ropivacaine for Perioperative Analgesia in Elderly Patients with Hip Fractures

作　　者：王敏 马雪 王亚琴 吴捷 WANG Min;MA Xue;WANG Yaqin;WU Jie(Department of Anesthesiology,Taizhou Hospital of Integrated Traditional Chinese and Western Medicine,Taizhou 225300,China)

机构地区：[1]泰州市中西医结合医院麻醉科,江苏泰州225300

出　　处：《反射疗法与康复医学》2025年第1期83-87,共5页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨超声引导下髂筋膜间隙阻滞联合轻比重罗哌卡因单侧腰部麻醉在老年髋部骨折患者围手术期镇痛中的效果。方法选取2022年6月—2024年5月泰州市中西医结合医院收治的110例老年髋部骨折患者为研究对象,按随机数字表法将其分为对照组和观察组,每组55例。对照组采用轻比重罗哌卡因单侧腰部麻醉,观察组在对照组的基础上采用超声引导下髂筋膜间隙阻滞。比较两组的血流动力学和血气指标、麻醉效果、镇静效果、镇痛效果、不良反应发生情况。结果整体分析发现,两组平均动脉压、心率、Ramsay镇静评分、疼痛视觉模拟评分时间、组间、交互作用比较,差异有统计学意义(P<0.05);两组动脉血氧饱和度组间比较,差异有统计学意义(P<0.05),动脉血氧饱和度时间、交互作用比较,差异无统计学意义(P>0.05)。观察组感觉阻滞起效时间、运动阻滞起效时间分别为(2.24±0.35)min、(6.11±0.14)min,均短于对照组的(3.59±0.55)min、(8.89±0.52)min,组间差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论超声引导下髂筋膜间隙阻滞联合轻比重罗哌卡因单侧腰部麻醉可维持老年髋部骨折患者的血流动力学稳定,改善镇静和镇痛效果,减轻术后疼痛程度,且未增加术后并发症发生风险。Objective To investigate the effect of ultrasound-guided fascia iliaca compartment block combined with unilateral lumbar anesthesia with hypobaric ropivacaine for perioperative analgesia in elderly patients with hip fracture.Methods A total of 110 elderly patients with hip fractures admitted to Taizhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2022 to May 2024 were selected as the research subjects,they were divided into a control group and an observation group according to the random number table method,with 55 patients in each group.The control group received umilateral lumbar anesthesia with hypobaric ropivacaine,and the observation group was treated with ultrasoundguided fascia iliaca compartment block on the basis of the control group.The hemodynamic and blood gas parameters,anesthetic effects,sedation effects,analgesic effects,and occurrence of adverse reactions were compared between the two groups.Results Overall analysis revealed that there were statistically significant differences in mean arterial pressure,heart rate,Ramsay sedation score,and Visual Analogue Scale for pain in terms of time,between-group comparison,and interaction between the two groups(P<0.05);the difference of arterial oxygen saturation between the two groups was statistically significant(P<0.05),but there were no statistically significant differences in terms of time and interaction of arterial oxygen saturation (P>0.05). The onset time of sensory block and motor block in the observation group was (2.24±0.35)min and (6.11±0.14)min, respectively, which were both shorter than (3.59±0.55)min and (8.89±0.52)min in the control group, and the between-group difference was statistically significant (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Ultrasound-Guided fascia iliac compartment block combined with unilateral lumbar anesthesia with hypobaric ropivacaine can maintain the hemodynamic stability in elderly pat

关 键 词：髋部骨折 髂筋膜间隙阻滞 超声引导 轻比重 罗哌卡因 

分 类 号：R683.42[医药卫生—骨科学]