本文已被:浏览 41次 下载 49次
投稿时间:2024-03-08 网络发布日期:2024-08-20
投稿时间:2024-03-08 网络发布日期:2024-08-20
中文摘要: 目的 比较超声引导下髂筋膜阻滞(FIB)与单纯椎管内麻醉对髋部骨折患者麻醉摆放体位及术后镇痛的影响。方法 选取2022年7月至2023年8月芜湖市中医医院收治的髋部骨折患者83例,随机分为临床组41例和对照组42例,临床组采用FIB联合椎管内麻醉,对照组采用单纯椎管内麻醉。比较两组麻醉效果、围术期的疼痛视觉模拟(VAS)评分及骨折恢复Bromage评分、术后48 h内麻醉药物用量、麻醉不良反应发生情况。结果 临床组麻醉总有效率95.12%,高于对照组的78.57%(χ2=4.943, P=0.026);临床组变换体位时和术后6、12、24、48 h的VAS评分均低于对照组(P<0.05);临床组镇痛后30 min及术后12~48 h的Bromage评分均低于对照组(P<0.05);临床组48 h内镇痛泵按压次数和枸橼酸舒芬太尼用量低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(χ2=0.001, P=0.970)。结论 FIB在麻醉摆放体位和静息时具有良好的镇痛效果,可加速术后下肢肌力和髋关节功能恢复,是缓解髋部骨折患者疼痛安全有效的方法。
Abstract:Objective To compare the influence of fascia iliaca block (FIB) under ultrasound and intraspinal anesthesia on anesthesia placement position and postoperative analgesia in patients with hip fractures. Methods A total of 83 patients with hip fractures admitted to Wuhu Hospital of Traditional Chinese Medicine from July 2022 to August 2023 were selected and divided into clinical group (41 cases) and control group (42 cases). The clinical group received FIB combined with intraspinal anesthesia, and the control group was given intraspinal anesthesia. Anesthesia effect, perioperative visual analogue scale (VAS) score, fracture recovery Bromage score, dosage of anesthetic drug within 48 h after surgery and occurrence of anesthesia adverse reactions were compared between the two groups. Results The total effective rate of anesthesia in clinical group was 95.12%, which was higher than 78.57% in control group (χ2=4.943, P=0.026). VAS scores in clinical group at the time of changing position and at 6, 12, 24 and 48 h after surgery were lower than those in control group (P<0.05). The Bromage scores in clinical group at 30 min after analgesia and 12 h to 48 h after surgery were lower than those in control group (P<0.05). The number of analgesic pump compression and dosage of sufentanil citrate within 48 h in clinical group were significantly lower than those in control group (P<0.05). There was no significant difference in adverse reactions between the two groups (χ2=0.001, P=0.970). Conclusion FIB has a good analgesia effect during anesthesia placement position and at rest, and it can accelerate the postoperative lower limb muscle strength and hip function recovery, and it is a safe and effective method to relieve pain in patients with hip fractures.
keywords: Fascia iliaca block, ultrasound-guide Intraspinal anesthesia Hip fractures Anesthesia placement position Postoperative analgesia Adverse reactions
文章编号: 中图分类号:R681.5 文献标志码:A
基金项目:芜湖市科技计划项目(2021cg25)
Author Name | Affiliation |
LIU Shanqun, YAN Yan, WEN Zuoqiang | Department of Anesthesiology, Wuhu Hospital of Traditional Chinese Medicine, Wuhu, Anhui 241000, China |
引用文本:
刘善群,严俨,温佐强.超声引导下髂筋膜阻滞对髋部骨折患者麻醉摆放体位及术后镇痛的影响[J].中国临床研究,2024,37(8):1259-1263.
刘善群,严俨,温佐强.超声引导下髂筋膜阻滞对髋部骨折患者麻醉摆放体位及术后镇痛的影响[J].中国临床研究,2024,37(8):1259-1263.