摘要
目的探讨B超引导下髂筋膜阻滞联合罗哌卡因单侧腰麻对老年髋关节手术快速康复的影响。方法选取2017年1月至2018年12月在中国人民解放军海军陆战队医院接受髋关节手术的老年患者56例,随机分为对照组和观察组;对照组患者在手术中采用罗哌卡因单侧腰麻的麻醉方法,观察组患者在手术中采用B超引导下髂筋膜阻滞联合罗哌卡因单侧腰麻的麻醉方法。结果麻醉后,对比2组患者的感觉与运动时间,患肢制动下的视觉模拟评分(RVAS)、患肢股四头肌等长收缩下的视觉模拟评分(PVAS)、警觉/镇静评分(OAA/S),术后不同时间的静息疼痛视觉模拟评分(VAS),术中不同时间运动疼痛VAS评分,术中镇痛效果满意度,术后并发症。麻醉后,观察组患者感觉阻滞见效、运动阻滞见效、感觉恢复、运动恢复时间均短于对照组患者(P<0.05);观察组患者RVAS、PVAS、OAA/S为1.8±0.2、1.2±0.5、2.9±0.8,对照组患者RVAS、PVAS、OAA/S为3.2±0.7、2.9±0.3、5.2±0.6,观察组均低于对照组(P<0.05);观察组患者术后2、4、8、24 h的静息疼痛VAS分别为2.4±0.3、1.8±0.7、1.4±0.4、1.2±0.1,对照组患者术后不同时间的静息疼痛VAS分别为4.3±1.7、3.9±1.4、3.1±0.8、2.4±0.5,观察组低于对照组患者(P<0.05);观察组患者术中不同时间运动疼痛VAS均低于对照组患者(P<0.05);观察组患者术中镇痛效果满意度为100%,高于对照组的96.4%(P<0.05);观察组患者术后并发症发生率低于对照组(P<0.05)。结论B超引导下髂筋膜阻滞联合罗哌卡因单侧腰麻有利于老年髋关节手术后患者的快速康复。
Objective To investigate the effect of ultrasonography-guided iliac fascia block combined with ropivacaine unilateral lumbar anesthesia on rapid recovery of elderly patients undergoing hip surgery. Methods Fifty-six elderly patients who received hip surgery in the Marine Corps Hospital from January 2017 to December 2018 were randomly divided into the control group and the observation group.The patients in the control group received ropivacaine unilateral lumbar anesthesia,while the patients in the observation group were anesthetized with ultrasonography-guided iliac fascia block combined with ropivacaine unilateral lumbar anesthesia.After anesthesia,following indicators,such as sensory and motor time,RVAS,PVAS and OAA/S scores were compared between the patients of the 2 groups.VAS pain scores at rest at 2 h/4 h/8 h/24 h after surgery,VAS motor pain scores at different time points during surgery,and satisfaction rate of analgesic effect during surgery and the rate of complications after surgery were also compared between the patients of the 2 groups. Results After anesthesia,the time of sensory block and motor block,sensory recovery and motor recovery time in the observation group were all shorter than those in the control group(P<0.05).The RVAS,PVAS and OAA/S scores of the patients in the observation group were respectively(1.8±0.2),(1.2±0.5)and(2.9±0.8),while those in the control group were(3.2±0.7),(2.9±0.3)and(5.2±0.6),with the scores of the observation group all being lower than those of the control group(P<0.05).VAS pain scores at rest at different time points after surgery for the observation group were respectively(2.4±0.3),(1.8±0.7),(1.4±0.4)and(1.2±0.1),while VAS pain scores at rest at different time points after surgery for the control group were respectively(4.3±1.7),(3.9±1.4),(3.1±0.8)and(2.4±0.5),with the scores of the observation group all being lower than those of the control group(P<0.05).VAS motor pain scores at different time points during surgery for the observation group were all
作者
聂杰
王飞
唐莉
Nie Jie;Wang Fei;Tang Li(Department of Anesthesiology,Marine Corps Hospital,CPLA,Chaozhou 521000,China)
出处
《海军医学杂志》
2019年第5期444-448,共5页
Journal of Navy Medicine
关键词
B超引导下髂筋膜阻滞
罗哌卡因
单侧腰麻
老年髋关节手术
Ultrasonography-guided iliac fascia block
Ropivacaine
Unilateral lumbar anesthesia
Hip surgery for elderly patients
