B超引导“领结征”髂筋膜阻滞联合患者自控镇痛用于髋关节置换术的镇痛效果

Analgesic effect of B-ultrasound-guided"bow-tie"fascia iliac block combined with patient-controlled analgesia for hip arthroplasty

目的探讨B超引导“领结征”髂筋膜阻滞联合患者自控镇痛(PCIA)用于髋关节置换术的镇痛效果。方法选取2018年6月至2020年12月本院收治的102例髋关节置换术患者作为研究对象,按随机数字表法分为对照组和观察组,每组51例。对照组采用全身麻醉联合PCIA镇痛,观察组采用B超引导“领结征”(沙漏征)髂筋膜阻滞+全身麻醉联合PCIA镇痛。比较两组术后疼痛程度、不良反应情况、PCIA按压次数及患者满意度、生命体征参数。结果术后3、6、12、24、48 h,观察组视觉模拟评分法(VAS)评分均低于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05);观察组PCIA按压次数少于对照组,满意度评分高于对照组(P<0.05);术前,两组生命体征参数比较差异无统计学意义;术后,观察组心率、血压、血氧饱和度均高于对照组,平均动脉压低于对照组,差异有统计学意义(P<0.05)。结论B超引导“领结征”髂筋膜阻滞+全身麻醉联合PCIA用于髋关节置换患者,可有效减轻术后疼痛,减少不良反应及PCIA按压次数,提升患者整体满意度,有助于稳定患者生命体征,促进其快速康复。

Objective To investigate the analgesic effect of B-ultrasound-guided"bow-tie"fascia iliac block combined with patient-controlled intravenous analgesia(PCIA)in hip arthroplasty.Methods 102 patients with hip arthroplasty admitted to our hospital from June 2018 to December 2020 were selected as research subjects,and they were divided into the control group and the observation group according to random number table method,with 51 cases in each group.The control group received general anesthesia combined with PCIA analgesia,the observation group received B-ultrasound-guided"bow-tie"sign(hourglass sign)iliac fascia block+general anesthesia combined with PCIA analgesia.Postoperative pain degree,adverse reactions,PCIA pressing times,patient satisfaction and vital signs parameters were compared between the two groups.Results At 3,6,12,24,48 h after operation,the visual analogue scale(VAS)score of the observation group was lower than the control group(P<0.05).The incidence of adverse reaction in observation group was lower than that in control group(P<0.05).The number of PCIA presses in the observation group was less than that in the control group,and the satisfaction score was higher than that in the control group(P<0.05).The preoperative vital sign parameters of the two groups were compared,and the above indexes were increased in the two groups after operation,and the observation group was significantly lower than the control group(P<0.05).Conclusion B-ultrasound-guided"bow-tie"iliac fascia block+general anesthesia combined with PCIA can effectively relieve postoperative pain,reduce adverse reactions,and the number of PCIA compressions,improve the overall satisfaction of patients,help stabilize patients'vital signs and promote rapid recovery.