全髋关节置换术后镇痛中超声引导下连续髂筋膜阻滞的应用分析

Application Analysis of Ultrasound-guided Continuous Fascia Block in Analgesia after Total Hip Arthroplasty

目的分析全髋关节置换术后镇痛中超声引导下连续髂筋膜阻滞的应用效果。方法采选2017年1月-2018年12月于该院接受全髋关节置换术治疗患者60例作为研究对象,按照随机数表法分为研究1组、研究2组,各30例,术后分别予以静脉芬太尼镇痛、超声引导下连续髂筋膜阻滞镇痛,对比术后不同时刻疼痛视觉模拟(VAS)评分、肌力评级、及术后并发症发生率情况。结果术后6 h、12 h、24 h、48 h,研究2组患者VAS评分均低于研究1组,差异有统计学意义(t=9.444、14.149、15.815、12.475,P<0.05);研究2组肌力评级与研究1组差异无统计学意义(P>0.05);研究2组头晕、胃肠道反应、皮肤瘙痒发生率(0.00%、0.00%、3.33%)均低于研究1组(16.67%、13.33%、20.00%),差异有统计学意义(χ^2=5.455、4.286、4.043,P<0.05)。结论全髋关节置换术后应用超声引导下连续髂筋膜阻滞镇痛,可有效缓解疼痛,减少并发症,效果及安全性俱佳。

Objective To analyze the effect of ultrasound-guided continuous fascia block in analgesia after total hip arthroplasty. Methods Sixty patients who underwent total hip arthroplasty in the hospital from January 2017 to December 2018 were enrolled in the study. According to the random number table method, they were divided into study group1 and study group 2, 30 cases each. Intravenous fentanyl analgesia, ultrasound-guided continuous fascia block analgesia, contrast pain visual analogue(VAS) score, muscle strength rating, and postoperative complication rate at different time points. Results At 6 h, 12 h, 24 h and 48 h after operation, the VAS scores of the two groups were lower than those of the study group 1,and the difference were statistically significant(t=9.444, 14.149, 15.815, 12.475, P<0.05).There was no statistically significant difference between the force rating and the study group(P>0.05). The incidence of dizziness, gastrointestinal reactions and skin itching in the two groups(0.00%, 0.00%, 3.33%) were lower than those in the study group 1(16.67%, 13.33%, 20.00%), the difference was statistically significant(χ^2=5.455, 4.286, 4.043, P<0.05). Conclusion Ultrasound-guided continuous iliac fascia block analgesia after total hip arthroplasty can effectively relieve pain, reduce complications, and have good effect and safety.