腰丛和髂筋膜阻滞在髋部骨折患者术后镇痛的应用比较

Comparison of the effect of lumbar plexus block and fascia iliaca block on postoperative analgesia in patients with hip fracture

目的:探讨超声引导腰丛阻滞和髂筋膜间隙阻滞在老年髋部骨折患者术后镇痛效果。方法:择期老年髋部骨折患者70例,在全身麻醉下行人工股骨头置换术,术毕随机分为腰丛阻滞组(LPB)和髂筋膜间隙阻滞组(FIB组),各35例。LBP组实施腰丛神经阻滞;FIB组实施髂筋膜间隙阻滞。记录术后VAS评分,评价镇痛效果;记录术后恶心呕吐、头晕等反应,评价镇痛不良反应。记录患者满意度和住院时间,评估神经阻滞对患者预后的影响。结果:与LPB组相比,FIB组患者住院时间更短,满意度更高(P<0.05)。结论:腰丛阻滞和髂筋膜间隙阻滞均可以用于老年髋部骨折患者术后镇痛,但髂筋膜间隙阻滞可以减少患者住院时间,患者满意度更高。

Objective:To compare the effects of ultrasound-guided lumbar plexus block and fascia iliaca block on postoperative analgesia in elderly patients with hip fracture.Methods:70 elderly patients with hip fractures were treated with artificial femoral head replacement under general anesthesia.After the operation,they were randomly divided into two groups (n=35):lumbar plexus block (LPB) group and fascia iliaca block (FIB) group,the group LBP was given lumbar plexus block,and the group FIB was given iliac fascia block.Record the postoperative VAS score to evaluate the analgesic effect;record the postoperative nausea,vomiting,dizziness and other reactions to evaluate the analgesic adverse reactions.Record patient satisfaction and length of hospital stay to evaluate the influence of nerve block on patient prognosis.Results:Compared with the group LPB,the patients of group FIB had shorter hospital stay and higher satisfaction (P<0.05).Conclusion:Both lumbar plexus block and iliac fascial space block can be used for postoperative analgesia in elderly patients with hip fractures.However,fascia iliaca block can reduce the length of hospital stay and increase patient satisfaction.