摘要
目的探讨超声引导下髋关节囊周围神经阻滞复合全身麻醉在老年髋关节置换术中的应用效果。方法选取2021年9月至2022年6月于江西省中西医结合医院接受髋关节置换术的老年患者75例为研究对象,根据随机数字表法将其分为A组、B组和C组,各25例。A组患者接受全身麻醉,B组患者接受超声引导下髋关节囊周围神经阻滞复合全身麻醉,C组患者接受超声引导下髂筋膜阻滞复合全身麻醉。分别于入室时、阻滞30 min后、术后2、8、12、24 h(T_(0)~T_(5))时采用视觉模拟评分法(VAS)评估患者的疼痛程度。手术后,记录三组患者镇痛泵首次按压时间、有效按压次数以及住院时间。比较三组术后谵妄、恶心呕吐、穿刺血肿、神经损伤等并发症发生情况。结果整体分析发现,三组组间、时间及交互作用比较差异均有统计学意义(P<0.05)。A组T_(2)~T_(5)的VAS评分低于本组T_(0),B组、C组T_(1)~T_(5)的VAS评分低于本组T_(0),差异有统计学意义(P<0.05);B组T_(1)~T_(4)的VAS评分低于A组、C组,C组T_(1)~T_(4)的VAS评分低于A组,差异有统计学意义(P<0.05)。A组、C组镇痛泵首次按压时间短于B组,有效按压次数多于B组,住院时间长于B组,差异有统计学意义(P<0.05)。A组镇痛泵首次按压时间短于C组,有效按压次数多于C组,住院时间长于C组,差异有统计学意义(P<0.05)。三组患者并发症总发生率的比较,差异无统计学意义(P>0.05)。结论超声引导下髋关节囊周围神经阻滞复合全身麻醉可以有效降低老年髋关节置换术患者术后疼痛,减少术后镇痛泵使用量,缩短住院时间。
Objective To explore the application effect of ultrasound-guided pericapsular nerve group block(PENG)combined with general anesthesia in elderly patients after hip replacement.Methods A total of 75 elderly patients who received hip replacement in Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to June 2022 were selected as the study objects,and were divided into group A,group B and group C according to random number table method,with 25 patients in each group.Group A received general anesthesia,group B received combined general anesthesia with hip capsular nerve block under ultrasound guidance,and group C received combined general anesthesia with iliac fascia block under ultrasound guidance.Visual analogue scale(VAS)was used to evaluate the pain degree of patients at the time of entry,30 min after block,and 2,8,12,and 24 h(T_(0)-T_(5))after surgery.After surgery,the first time of analgesic pump compression,the number of effective compressions and the length of hospital stay were recorded in the three groups.Postoperative delirium,nausea and vomiting,puncture hematoma,nerve injury and other complications were compared among the three groups.Results The overall analysis showed that there were statistically significant differences among the three groups(P<0.05).VAS score of T_(2)-T_(5)in group A was lower than that of T_(0),and VAS scores of T_(1)-T_(5)in group B and C were lower than those of T_(0),and the differences were statistically significant(P<0.05).The VAS score of T_(1)-T_(4)in group B was lower than that in group A and C,and the VAS score of T_(1)-T_(4)in group C was lower than that in group A,the differences were statistically significant(P<0.05).The first time of analgesic pump compression in group A and C were shorter than that in group B,the number of effective compression were more than that in group B,and the length of hospital stay were longer than that in group B,the differences were statistically significant(P<0.05).The first time of analgesi
作者
陈斌
胡海涛
邓伦童
刘云洁
梅海翔
伍江华
付昕尧
万达
CHEN Bin;HU Haitao;DENG Luntong;LIU Yunjie;MEI Haixiang;WU Jianghua;FU Xinyao;WAN Da(Department of Anesthesiology,Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Jiangxi Province,Nanchang330003,China)
出处
《中国当代医药》
CAS
2023年第13期118-121,129,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202211472)。
