不同浓度罗哌卡因髂筋膜阻滞老年患者下肢手术围手术期镇痛研究

Study on perioperative analgesic effects of iliac fascia blockwith ropivacaine at different concentrations on elderly patients during lower limb surgery

目的:探讨不同浓度罗哌卡因髂筋膜阻滞老年患者下肢手术围手术期镇痛效果。方法:选取2019年3月至2020年10月90例在本院进行下肢手术患者分为A、B、C三组,均给予罗哌卡因髂筋膜阻滞,浓度分别为0.25%、0.375%、0.4%,比较三组患者各时间点心率、平均动脉压、静息和运动VAS评分、不良反应发生率及满意率。结果:与T0时间点比较T1、T2、T3时间点三组患者心率及平均动脉压均有所波动,但是各时间点三组患者心率及平均动脉压无显著性差异(P>0.05);T0、T6、T8时间点静息和运动状态下三组患者VAS评分无显著性差异(P>0.05),T4、T5时间点A组静息VAS评分均显著高于B、C组(P<0.05),T4、T5、T7时间点A组运动VAS评分均显著高于B、C组(P<0.05);B、C组患者不良反应发生率均为16.67%,较A组的30.00%显著降低(P<0.05)。结论:罗哌卡因髂筋膜阻滞应用于老年下肢手术患者,阻滞和镇痛效果满意,0.375%、0.4%罗哌卡因的效果相当,优于0.25%罗哌卡因,0.4%罗哌卡因的镇痛时间更长。

Objective:To investigate and analyze the perioperative analgesic effects of iliac fascia block with ropivacaine at different concentrations on elderly patients.Methods:90 patients who underwent lower extremity surgery in People’s Hospital of Chenghai from March 2019 to October 2020 were chosen and divided into Group A,Group B,and Group C.They were all given iliac fascia block with ropivacaine at the concentration of 0.25%,0.375%,and 0.4%respectively,with the heart rate,the mean arterial pressure,the VAS scores at rest and during the exercise,the adverse reaction rate and the satisfaction rate at different time points compared.Results:Compared with those at T0 time point,the heart rate and the mean arterial pressure of the three groups at T2 and T3 time points fluctuated,but there was no significant difference in the heart rate and the mean arterial pressure of the three groups at each time point(P>0.05).There was no significant difference in patients’VAS scores at rest and during movement at T0,T6,and T8(P>0.05).The resting VAS scores of Group A at T4 and T5 were significantly higher than those of Group B and Group C(P<0.05).The VAS scores during movement of Group A at T4,T5 and T7 were significantly higher than those in Group B and Group C(P<0.05).The incidence of adverse reactions in Group B and Group C was both 16.67%,which was significantly lower than that in group A(30.00%)(P<0.05).Conclusion:Iiliac fascia block with ropivacaine is effective in elderly patients with lower limb surgery,with the effect of block and analgesia satisfactory.0.375%and 0.4%ropivacaine are much better than 0.25%ropivacaine,with 0.4%ropivacaine having a longer analgesic effect.