超声引导髂筋膜间隙阻滞对老年股骨粗隆间骨折术后情况的影响

Impact of ultrasound-guided fascia iliac compartment block on postoperative conditions in elderly patients suffered with femoral intertrochanteric fractures

目的探讨超声引导髂筋膜间隙阻滞对老年股骨粗隆间骨折手术术后镇痛效果及外周血炎症因子水平的影响。方法选择2018年1—12月本院收治的老年股骨粗隆间骨折手术患者90例进行研究,将患者随机分为观察组和对照组两组,每组各45例。对照组行全身麻醉;观察组行全身麻醉+超声引导髂筋膜间隙阻滞麻醉,对两组镇痛效果进行比较。结果观察组麻醉苏醒时间、拔管时间均短于对照组(P<0.05),瑞芬太尼用量、丙泊酚用量均小于对照组(P<0.05);出麻醉恢复室前、术后24 h疼痛评分(VAS)比较,观察组均低于对照组(P<0.05);麻醉前比较,两组各项血清炎症因子水平均无较大差异(P>0.05);拔管后,两组比较各指标差异均存在明显意义(P<0.05)。结论超声引导髂筋膜间隙置管在老年股骨粗隆间骨折手术患者中有较高的应用价值,可推广应用。

Objective To investigate the affects of ultrasound-guided iliac fascial space block on the analgesic effect and inflammatory factor levels in peripheral blood in elderly patients with intertrochanteric fractures.Methods 90 patients of elderly patients suffered with femoral intertrochanteric fractures those treated in our hospital from January to December 2018 were selected and were randomly divided into two groups,45 patients received general anesthesia were enrolled in the control group,the other 45 patients received both ultrasound-guided fascia iliac compartment block and general anesthesia were enrolled in the observation group,and the analgesic effects of the two groups were compared.Results The awaking time and extubation time in the observation group were shorter than those in the control group,and the dosage of remifentanil and propofol were less than those in the control group(P<0.05).The VAS scores of patients in the observation group were significantly lower than those in the control group at both time points before they exited from the anaesthesia recovery room and 24 hours after surgery(P<0.05).There was no significant difference in serum levels of inflammatory cytokines between the two groups before anesthesia(P>0.05).There were significant differences in the above indexes between the two groups after anesthesia(P<0.05).Conclusions Ultrasound-guided fascia iliac compartment block is of high application value in elderly patients with femoral intertrochanteric fractures and should be widely used.