摘要
目的:观察超声引导下改良髂筋膜间隙阻滞(FICB)复合静脉麻醉(IA)应用于老年股骨转子间骨折(IFF)手术的效果。方法:选取医院收治的99例老年IFF手术患者,根据门诊就诊号信息将单数患者纳入对照组(50例),双数患者纳入观察组(49例),对照组采用IA方法,观察组实施超声引导下改良FICB复合IA方法。比较两组患者麻醉恢复的苏醒时间、拔管时间及舒芬太尼用量;于术后6h、12 h及24 h时采用视觉模拟量表(VAS)评分比较两组疼痛程度,并观察比较两组不良事件发生情况。结果:观察组麻醉恢复的苏醒时间、拔管时间均短于对照组,且舒芬太尼用量少于对照组,差异有统计学意义(U=6.341,U=5.697,U=6.915;P<0.05);术后12 h和24 h,两组VAS评分均较术后6 h下降,且观察组各时点VAS评分均低于对照组,差异有统计学意义(U=146.574,P<0.05);两组不良事件发生率比较,差异无统计学意义(x^(2)=0.090,P>0.05)。结论:超声引导下改良FICB复合IA应用于老年IFF手术中镇痛效果更好,可减轻患者术后疼痛感,缩短麻醉恢复时间,减少舒芬太尼用量,且不良事件少,手术安全可靠。
Objective:To observe the effect of modified fascia iliaca compartment block(FICB)combined with intravenous anesthesia(IA)under ultrasound-guidance in elderly patients with the surgery of intertrochanteric fractures of femur(IFF).Methods:99 elderly patients with IFF surgery who admitted to hospital were prospectively selected as the research subjects,and they were divided into control group(50 cases with odd numbers)and observation group(49 cases with even numbers)according to the information of the odd or even numbers of outpatient list.The control group adopted IA for anesthesia,and observation group underwent modified FICB combined with IA under ultrasound-guidance.The recovery time of anesthesia,the extubation time and the used dose of sufentanil between two groups were compared.And the score of visual analogue scale(VAS)was adopted to compare the pain degree between two groups,and the occurrences of adverse events between two groups were further observed and compared.Results:Both the recovery time and extubation time of observation group were significantly shorter than those of control group,and the dosage of sufentanil of observation group was significantly less than that of control group(U=6.341,U=5.697,U=6.915,P<0.05).Compared with the VAS scores postoperative 6 hours,they decreased at the 12 th h and 24 th h post operation.And the VAS scores of observation group were lower than those of control group at various time point,and the differences of them between two groups were significant(U=146.574,P<0.05).And the difference of adverse event between two groups were significant(x^(2)=0.090,P<0.05).Conclusion:Application of modified FICB combined with IA under ultrasound-guidance is better in intraoperative analgesic effect for elderly patients who undergo IFF surgery,which can relieve the postoperative pain,and shorten the recovery time of anesthesia,and reduce the dosage of sufentanil in patients,and its adverse events are few,and the surgery uses that is safe and reliable.
作者
陆振民
庞虹亮
吕宝胜
苗慧
LU Zhen-min;PANG Hong-liang;LV Bao-sheng(Department of Anesthesiology,Yanda Hospital Affiliated to Hebei Medical University,Langfang 065200,China;不详)
出处
《中国医学装备》
2022年第1期100-103,共4页
China Medical Equipment
