分析超声引导髂筋膜连续神经阻滞在下肢不同区域术后镇痛的应用效果

Analysis on the Effect of Ultrasound-guided Continuous Nerve Block of the Iliac Fascia on Postoperative Analgesia in Different Areas of the Lower Extremities

目的探讨在进行下肢不同区域术后镇痛期间超声引导髂筋膜连续神经阻滞方式运用可行性。方法选取2018年1月—2020年12月该院收治的下肢不同区域术后镇痛患者60例进行研究,随机分为参照组(选择外周静脉镇痛方法完成临床麻醉)和研究组(选择超声引导髂筋膜连续神经阻滞方法完成临床麻醉),各30例。比较两组患者曲马多用量、术后镇痛不良反应(恶心、感染、呕吐、低血压、尿潴留、胸闷)总发生率以及术后不同时间段(3、6、9 h)视觉模拟疼痛评分(VAS评分)。结果研究组术后曲马多用量(50.25±5.25)mg少于参照组(152.29±5.29)mg,差异有统计学意义(t=74.989,P<0.05);研究组术后镇痛不良反应(恶心、感染、呕吐、低血压、尿潴留、胸闷)总发生率(20.00%)低于参照组(50.00%),差异有统计学意义(χ^(2)=5.934,P<0.05);研究组术后3 hVAS评分(1.29±0.25)分、术后6 hVAS评分(1.92±0.51)分以及术后9 hVAS评分(1.83±0.75)分均低于参照组(4.25±0.62)分、(4.69±0.73)分、(3.92±0.71)分,差异有统计学意义(t=24.251、17.037、11.084,P<0.05)。结论超声引导髂筋膜连续神经阻滞方式有效应用后,患者术后镇痛不良反应发生率降低,术后疼痛显著缓解,不同区域术后镇痛患者预后水平显著提升。

Objective To explore the feasibility of using ultrasound-guided continuous nerve block of the iliac fascia during postoperative analgesia in different areas of the lower extremities.Methods A total of 60 patients in the hospital with postoperative analgesia in different regions of the lower extremities who were admitted from January 2018 to December 2020 were selected for research.They were randomly divided into reference group(choose peripheral intravenous analgesia to complete clinical anesthesia)and study group(choose ultrasound-guided iliac fascia continuous nerve block to complete clinical anesthesia),30 cases in each group.Compared the dosage of tramadol,the total incidence of postoperative analgesia(nausea,infection,vomiting,hypotension,urinary retention,chest tightness)and the visual simulated pain score(VAS score)in different time periods(3 h,6 h and 9 h)after operation.Results The postoperative tramadol dosage(50.25±5.25)mg in the study group was less than the(152.29±5.29)mg in the reference group,the difference was statistically significant(t=74.989,P<0.05).The total incidence of postoperative analgesia(nausea,infection,vomiting,hypotension,urinary retention,chest tightness)in the study group(20.00%)was lower than that in the reference group(50.00%),the difference was statistically significant(χ^(2)=5.934,P<0.05).In the study group,the 3 hVAS score(1.29±0.25)points after the operation,the 6 hVAS score(1.92±0.51)points after the operation,and the 9 hVAS score(1.83±0.75)points after the operation were all lower than the reference group's(4.25±0.62)points,(4.69±0.73)points,(3.92±0.71)points,the difference was statistically significant(t=24.251,17.037,11.084,P<0.05).Conclusion After the effective application of ultrasound-guided iliac fascia continuous nerve block,the incidence of postoperative analgesic adverse reactions was reduced,the postoperative pain was significantly relieved,and the prognosis of postoperative analgesia patients in different regions was significantly improved.