超声引导下腰方肌阻滞在髋关节术后镇痛中的价值

Value of Ultrasonic-guided Quadratus Lumborum Blockin Postoperative Analgesia of Hip Joint

目的︰研究超声引导下腰方肌阻滞在髋关节术后镇痛中的价值。方法﹐将2017年1月-2019年12月于唐山市第二医院拟行髋关节置换术的84例患者,以随机数字表法分为观察组和对照组各42例。对照组实施超声引导下骼筋膜间隙阻滞,观察组则实施超声引导下腰方肌阻滞。比较两组术后不同时间点的舒芬太尼使用剂量,静息,运动时的疼痛程度。结果﹑观察组术后12 h.24 h及48 h时的舒芬太尼使用剂量均少于对照组,差异有统计学意义(P<0.05)。观察组术后24 h,48 h时的静息视觉模拟评分法(VAS)评分均低于对照组,且观察组术后12 h,24 h,48 h的运动VAS评分均低于对照组,差异有统计学意义(P<0.05).结论―超声引导下腰方肌阻滞在髋关节术后镇痛中的效果显著,可有效减少舒芬太尼使用剂量,同时可明显减轻患者疼痛。

Objective To study and analyze the value of ultrason-guided quadratus lumborum block inpostoperative analgesia of hip joint.Methods A total of 84 patients undergoing hip arthroplasty in our hospitalfrom January 2017 to December 2019 were included.They were divided into observation group and control group byrandom number table method,42 cases in cach group.The control group was treated with ultrasound-guided fasciailiaca compartment block,while the observation group was treated with ultrasound-guided quadratus luborum block.The dosage of sufentanil,the pain degree during rest and exercise were compared between the two groups at differenttime points after operation.Results The dose of sufentanil in observation group was significantly lower than controlgroup at 12 h,24 h and 48 h after operation(P<0.05).The resting VAS scores of observation group at 24 h and 48 hafter surgery were significantly lower than control group,and exercise VAS scores of the observation group at 12 h,24 h and 48 h after surgery were significantly lower than control group(P<0.05).Conclusion Ultrasound-guidedquadratus lumborum block has a significant effect on postoperative analgesia of hip joint,can reduce the dosage ofsufentanil effectively,and reduce the pain of patients significantly.