术前与术后髂筋膜间隙阻滞镇痛在老年髋关节置换术患者中的应用对比

Comparison of Preoperative and Postoperative Iliac Fascia Gap Block Analgesia in Elderly Patients with Hip Replacement

目的对比术前、术后髂筋膜间隙阻滞(FICB)镇痛在老年髋关节置换术患者中的研究意义。方法选取我院2018年8月至2020年12月老年髋关节置换术患者76例,按随机数字表法分为实验组、对照组,每组各38例,实验组采用术前FICB镇痛,对照组采用术后FICB镇痛。对比两组术前(T_(0))、术后4h(T_(1))、术后8h(T_(2))、术后12h(T_(3))、术后24h(T_(4))、术后48h(T_(5))认知功能和术后4h(T_(1))、术后8h(T_(2))、术后12h(T_(3))、术后24h(T_(4))术后疼痛情况,并比较麻醉药物用量及并发症发生率。结果T_(1)、T_(2)、T_(3)、T_(4)时实验组疼痛评分较对照组低(P<0.05);实验组瑞芬太尼、丙泊酚及舒芬太尼用量较对照组少(P<0.05);T_(1)、T_(2)、T_(3)、T_(4)时实验组认知功能评分较对照组高(P<0.05);实验组并发症发生率5.26%(2/38)与对照组10.53%(4/38)对比无显著差异(P>0.05)。结论术前应用FICB镇痛的老年髋关节置换术患者,可减少麻醉药物用量,预防术后早期认知功能障碍,并具有良好镇痛效果和安全性。

Objective To compare the significance of preoperative and postoperative iliac fascia gap block(FICB)analgesia in elderly patients with hip replacement.Methods 76 elderly patients with hip replacement from August 2018 to December 2020 were selected and divided into experimental group and 38 patients in each group with preoperative FICB analgesia and postoperative FICB analgesia in the control group.The preoperative(T_(0)),4h(T_(1)),8h(T_(2)),12h(T_(3)),24h(T_(4)),48h(T_(5)),4h(T_(1)),8h(T_(2)),12h(T_(3)),and 24h(T_(4)),and the amount of anesthetic drugs and the incidence of complications were compared.Results The pain scores in T_(1),T_(2),T_(3) and T_(4)(P<0.05);the use of rifentanyl and propofol(P<0.05);the cognitive function scores in T_(1),T_(2),T_(3) and T_(4)(P<0.05)and the incidence of complications was 5.26%(2/38)and 10.53%(4/38)(P>0.05).Conclusion Elderly hip replacement patients with preoperative FICB analgesia can reduce the amount of anesthetic drugs,prevent early postoperative cognitive dysfunction,and have good analgesic effect and safety.