布比卡因脂质体腘窝坐骨神经阻滞对跟骨骨折术后镇痛的影响  

Effect of bupivacaine liposome popliteal sciatic nerve block on postoperative analgesia in patients with calcaneal fracture Shao

作　　者：邵忠新[1] 王烺 林全阳[1] 马保新[1] 林文新 Zhongxin;Wang Lang;Lin Quanyang;Ma Baoxin;Lin Wenxin(Department of Anesthesiology,Zhongshan Hospital of Xiamen University,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院手术麻醉科,福建厦门361004

出　　处：《实用药物与临床》2025年第4期246-251,共6页Practical Pharmacy and Clinical Remedies

摘　　要：目的探究布比卡因脂质体腘窝坐骨神经阻滞对跟骨骨折术后镇痛的影响,评价其有效性和安全性。方法选取厦门大学附属中山医院2024年4-8月择期行跟骨骨折手术患者60例,按随机数字表法分为布比卡因脂质体组和布比卡因组,每组30例。两组均在麻醉诱导前60 min超声引导腘窝坐骨神经阻滞,布比卡因脂质体组注射布比卡因脂质体10 ml+生理盐水10 ml,布比卡因组注射0.75%布比卡因10 ml+生理盐水10 ml。两组均复合喉罩全麻。记录两组患者麻醉恢复室(Post-anesthesia care unit,PACU)期间及术后12 h、24 h、36 h、48 h、60 h和72 h静息和运动时的视觉模拟评分法(Visual Analogue Scale,VAS)评分;记录两组患者感觉和运动阻滞起效时间、持续时间和阻滞发生率;记录患者术后镇痛药总量、无需阿片镇痛率和术后首次使用阿片药物时间;记录两组患者不良反应和满意率。结果布比卡因脂质体组与布比卡因组的术后24 h、36 h、48 h和60 h静息时VAS评分分别为[(2.73±0.98)vs.(3.50±0.93)]、[(2.40±0.96)vs.(3.71±1.39)]、[(2.30±1.17)vs.(3.27±1.08)]、[(2.01±1.02)vs.(2.70±1.42)],差异有统计学意义(P<0.05),术后24 h、36 h、48 h运动时VAS评分[(2.86±0.86)vs.(3.83±0.94)]、[(3.03±0.92)vs.(4.10±1.34)]、[(2.83±1.05)vs.(3.56±1.16)],差异有统计学意义(P<0.05)。与布比卡因组比较,布比卡因脂质体组感觉、运动阻滞起效时间明显增加,感觉阻滞持续时间显著延长,运动阻滞持续时间缩短,运动阻滞发生率明显降低,差异有统计学意义(P<0.05);布比卡因脂质体组术后镇痛药总量[(13.4±8.84)mg vs.(40.35±14.73)mg]减少,无需阿片镇痛率[9(30%)vs.2(6.7%)]提高,差异有统计学意义(P<0.05);两组患者术后首次使用阿片药物时间、不良反应和满意度比较,差异无统计学意义(P>0.05)。结论布比卡因脂质体超声引导腘窝坐骨神经阻滞用于跟骨骨折术后镇痛效果确切,镇痛持久,运动阻�Objective To investigate the effect of bupivacaine liposome popliteal sciatic nerve block on postoperative analgesia in patients with calcaneal fracture,and evaluate its efficacy and safety.Methods A total of sixty patients who underwent elective calcaneal fracture surgery at Zhongshan Hospital Affiliated to Xiamen University from April 2024 to August 2024 were selected and divided into the bupivacaine liposome group and the bupivacaine group according to the random number table method,with 30 cases in each group.Ultrasound-guided popliteal sciatic nerve block was performed 60 min before anesthesia induction in both groups.The bupivacaine liposome group received an injection of 10 ml of bupivacaine liposome+10 ml of normal saline,a total of 20 ml.The bupivacaine group received an injection of 10 ml of 0.75% bupivacaine+10 ml of normal saline,a total of 20 ml.Both groups were anesthetized with laryngeal mask airway.The Visual Analogue Scale(VAS)scores at rest and during exercise were recorded during PACU,and at 12 h,24 h,36 h,48 h,60 h and 72 h after surgery.The onset time,duration and incidence of sensory and motor block in both groups were recorded.The total amount of postoperative analgesics,the rate of opioid-free analgesia and the time of first use of opioids after surgery were recorded.The adverse reactions and satisfaction rates of the two groups were recorded.Results The VAS scores of the bupivacaine liposome group and the bupivacaine group at rest at 24 h,36 h,48 h and 60 h after surgery were[(2.73±0.98)vs.(3.50±0.93)],[(2.40±0.96)vs.(3.71±1.39)],[(2.30±1.17)vs.(3.27±1.08)],and[(2.01±1.02)vs.(2.70±1.42)],respectively,and the differences were statistically significant(P<0.05).The VAS scores during exercise at 24 h,36 h and 48 h after surgery were[(2.86±0.86)vs.(3.83±0.94)],[(3.03±0.92)vs.(4.10±1.34)],and[(2.83±1.05)vs.(3.56±1.16)],respectively,and the differences were statistically significant(P<0.05).Compared with the bupivacaine group,the onset time of sensory and motor block in the bupivac

关 键 词：布比卡因脂质体 超声引导 腘窝坐骨神经阻滞 跟骨骨折 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]