超声引导下髂筋膜间隙-骶丛神经阻滞在老年髋部手术中的应用

Application of Ultrasound-guided Iliac Fascia Space Sacral Plexus Block in Elderly Hip Surgery

目的探讨超声引导下髂筋膜间隙阻滞联合骶丛神经阻滞在老年髋部手术中的麻醉效果和术后镇痛评价。方法选择老年单侧髋部手术患者70例,随机数字表法分为对照组和观察组,每组35例,分别实施超声引导下单次蛛网膜下腔阻滞及超声引导下腹股沟韧带上髂筋膜间隙阻滞联合骶丛神经阻滞,比较两种麻醉方式的麻醉效果、术中生命征情况、不良反应及术后镇痛评分等。结果两种麻醉方式总有效率对比无统计学意义(P>0.05);观察组尿潴留发生率明显低于对照组(P<0.05);观察组术后6 h疼痛VAS评分低于对照组(P<0.05)。结论超声引导下腹股沟韧带上髂筋膜间隙阻滞联合骶丛神经阻滞应用于老年髋部手术麻醉有效率高,舒适度好,利于老年患者快速康复,临床应用价值高。

Objective To investigate the anesthetic effect and postoperative analgesia of ultrasound-guided iliac fascia space block combined with sacral plexus block in elderly hip surgery.Methods Seventy elderly patients undergoing unilateral hip surgery were randomly divided into control group and observation group,with 35 cases in each group.Ultrasound-guided single subarachnoid block and ultrasound-guided superior iliac fascial space block combined with sacral plexus block were performed respectively.Compare the anesthesia effects,intraoperative vital signs,adverse reactions and postoperative analgesia scores of the two anesthesia methods.Results There was no significant difference in the total effective rate between the two anesthesia methods(P>0.05);The incidence of urinary retention in observation group was significantly lower than that in control group(P<0.05).The VAS score of pain 6 hours after operation in the observation group was lower than that in the control group(P<0.05).Conclusion Ultrasound-guided superior iliac fascial space block of inguinal ligament combined with sacral plexus block in elderly hip surgery has high anesthesia efficiency,good comfort,is conducive to the rapid rehabilitation of elderly patients,and has high clinical application value.