CFICB应用于全髋关节置换术后镇痛的效果分析

Analysis of the Efficacy of CFCB Applied to Analgesia after Total Hip Arthroplasty

目的探讨超声引导下连续髂筋膜阻滞(CFICB)应用于老年全髋关节置换(THA)术后的镇痛效果.方法选择2018年6月至2019年6月于肇庆市广宁县中医院接受治疗的THA患者56例为研究对象,使用随机数字表法分为对照组(28例)和观察组(28例);对照组术后采用自控静脉镇痛;观察组采取麻醉前30min行CFICB,术后采用CFICB.观察比较两组48h患者满意度;两组患者术后6、12、24、48 h静息时VAS评分及术后24、48 h运动时VAS评分以及术后补救镇痛情况;两组患者术后下地时间、住院天数及不良反应发生情况.结果观察组术后基本满意及以上患者人数为25人,满意度89.29%,对照组基本满意及以上人数为18人,满意度为64.29%,即观察组患者的满意度显著高于对照组(P<0.05);观察组患者术后6、12、24、48 h静息时VAS评分及术后24、48 h运动时VAS评分低于对照组患者(P<0.05);观察组患者术后下地时间及住院天数显著短于对照组(P<0.05).观察组患者术后有2例发生恶心呕吐,不良反应发生率为7.14%;对照组患者术后1例发生头晕,8例发生恶心呕吐,3例发生皮肤瘙痒,术后不良反应发生率为42.86%,显著高于观察组(P<0.05).结论THA患者采取超声引导下CFICB,具有良好的镇痛效果,可显著提高患者满意度,缩短下地时间及住院时间,降低不良反应发生率,安全性好,值得临床推广.

Objective To investigate the analgesic efficacy of ultrasound-guided continuous fascia iliaca compartment block(CFCB)applied to elderly patients after total hip arthroplasty(THA).Methods Fifty six THA patients treated in Guangning County Hospital of Traditional Chinese Medicine from June 2018 to June 2019 were selected as the study subjects and divided into control(n=28)and observation(n=28)groups using the random number table method.In the control group,postoperative self-controlled intravenous analgesia was used;in the observation group,cficb was performed 30 min before anesthesia was taken,and postoperative cficb was used.Patients’satisfaction at 48 h,VAS scores at rest at 6,12,24,and 48 h postoperatively and exercise at 24 and 48 h postoperatively as well as rescue analgesia postoperatively were observed and compared between the two groups.Results The number of patients who were basically satisfied and above after surgery in the observation group was 25,with 89.29%satisfaction,while the number of patients who were basically satisfied and above in the control group was 18,with 64.29%satisfaction,that is,the satisfaction of patients in the observation group was significantly higher than that of the control group(P<0.05).The VAS scores of patients in the observation group at rest at 6,12,24,and 48 h after surgery and at 24 and 48 h lower VAS score at exercise(P<0.05)and patients in the observation group had a significantly shorter postoperative landing time and hospital stay(P<0.05)than patients in the control group.Two patients in the observation group developed nausea and vomiting postoperatively,with an adverse event rate of 7.14%;one patient in the control group developed dizziness postoperatively,eight patients developed nausea and vomiting,and three patients developed skin itching,with an adverse event rate of 42.86%,which was significantly higher than that in the observation group(P<0.05).Conclusion The patients with cficb under ultrasound guidance have a good analgesic effect,which can significantly improve patient satisfaction,reduce the time to downstaging and hospital stay,reduce the incidence of adverse effects,and have a good safety profile,which is worthy of clinical promotion.