摘要
目的 观察髂筋膜联合腰方肌阻滞中不同浓度的罗哌卡因在老年人髋关节置换术后的镇痛效果。方法 选择2019年2月~2020年3月在华北医疗健康集团邢台总医院择期行单侧髋关节置换术患者110例,根据随机数字表法分为低浓度组和高浓度组,各55例,其中1例术中改为全身麻醉退出研究,高浓度组实际54例。术后均接受髂筋膜联合腰方肌阻滞方法进行镇痛,其中低浓度组采用0.2%罗哌卡因28 ml的局麻药物,而高浓度组采用0.33%罗哌卡因17 ml的局麻药物。比较两组术后3 h、6 h、12 h、24 h、36 h及48 h的视觉模拟量表(VAS)评分,术后24 h、36 h及48 h曲髋时的VAS评分,镇痛补救药物的用量及不良反应发生情况。结果 低浓度组术后3 h、6 h、12 h、24 h、36 h及48 h的VAS评分低于高浓度组,低浓度组曲髋运动24 h、36 h及48 h的VAS评分均低于高浓度组,低浓度组术后12 h、24 h、36 h及48 h镇痛药物的使用剂量少于高浓度组,低浓度组术后恶心呕吐发生率低于高浓度组,差异均有统计学意义(P<0.05)。结论 老年人在髋关节置换术后采用髂筋膜联合腰方肌阻滞镇痛时,0.2%罗哌卡因是理想的选择。
Objective To evaluate the analgesic efficacy of different concentrations of ropivacaine in fascia iliaca block combined with quadratus lumborum block for older patients after hip arthroplasty.Methods A total of 110 patients undergoing elective unilateral hip arthroplasty in Xingtai General Hospital of North China Medical Health Group from February 2019 to March 2020 were included in this study.The patients were divided into a low concentration group(55 cases) and a high concentration group(55 cases, of which 1 case was given general anesthesia and withdrawn from this study) according to random number table.All patients received postoperative analgesia by fascia iliaca block and quadratus lumborum block.Patients in the low concentration group received 0.2% ropivacaine 28 ml, and patients in the high concentration group received 0.33% ropivacaine 17 ml.The visual analogue scale(VAS) scores at 3,6,12,24,36,and 48 hours after surgery;VAS scores during hip flexion at 24,36,and 48 hours after surgery;the consumption of analgesic drugs and occurrence of adverse reactions were compared between the two groups.Results VAS scores at 3,6,12,24,36,and 48 hours after operation were lower in the low concentration group than in the high concentration group.VAS scores during hip flexion at 24,36,and 48 hours after operation were lower in the low concentration group than in the high concentration group.Compared with the high concentration group, the use of analgesic drugs at 12,24,36,and 48 hours after operation, and the incidence of postoperative nausea and vomiting were decreased in the low concentration group.The differences between the two groups were statistically significant(P<0.05).Conclusion The use of 0.2% ropivacaine is an ideal choice for postoperative analgesia by fascia iliaca block and quadratus lumborum block in older patients undergoing hip arthroplasty.
作者
孟华
刘文娜
Meng Hua;Liu Wenna(Department of Anesthesiology,Xingtai General Hospital,North China Medical Health Group,Xingtai 054000)
出处
《国际老年医学杂志》
2022年第5期599-602,共4页
International Journal of Geriatrics
基金
河北省卫计委医学科研项目(20201268)。
关键词
髋关节置换术
罗哌卡因
髂筋膜阻滞
腰方肌阻滞
术后镇痛
Hip arthroplasty
Ropivacaine
Fascia iliaca block
Quadratus lumborum block
Postoperative analgesia
