超声引导下髂筋膜阻滞在老年髋关节置换术中的应用效果

Application Effect of Iliac Fascia Block under Ultrasound Guidance in Hip Arthroplasty in the Elderly

目的:观察超声引导下髂筋膜阻滞在老年髋关节置换术中的应用效果。方法:选取2021年1-12月漳州市第三医院60例接受髋关节置换术的老年患者。随机将其分为常规组及研究组,各30例。常规组给予气管插管全身麻醉,研究组给予超声引导下髂筋膜阻滞联合气管插管全身麻醉。比较两组术前及术后的心率及平均动脉压,围手术期指标,术后24 h及3、6、15 d疼痛程度,术后12、24、48 h运动阻滞情况及不良反应。结果:术后,研究组心率及平均动脉压均高于常规组(P<0.05)。研究组拔管时间、观察监测时间、下床活动时间均优于常规组,术后48 h镇痛满意度评分高于常规组(P<0.05)。术后24 h及3、6、15 d,研究组VAS评分低于常规组(P<0.05)。两组术后12、24、48 h的Bromage评分比较差异均无统计学意义(P>0.05)。研究组麻醉后不良反应发生率低于常规组(P<0.05)。结论:超声引导下髂筋膜阻滞应用于老年髋关节置换术中能够有效降低不良反应发生率,取得较好镇痛效果,稳定心率及平均动脉压,使患者尽早下床活动。

Objective:To observe the application effect of iliac fascia block under ultrasound guidance in hip arthroplasty in the elderly.Method:From January to December 2021,60 elderly patients who received hip arthroplasty in Zhangzhou Third Hospital were selected.They were randomly divided into routine group and study group,30 cases in each group.The routine group was given general anesthesia by tracheal intubation,and the study group was given iliac fascia block under ultrasound guidance combined with general anesthesia by tracheal intubation.The heart rate and mean arterial pressure before and after operation,perioperative indexes,pain degree at 24 hours,3,6 and 15 days after operation,motor block condition at 12,24 and 48 hours after operation and adverse reactions were compared between the two groups.Result:After operation,the heart rate and mean arterial pressure in the study group were higher than those in the routine group(P<0.05).The time of decannulation,observation and monitoring time,and time of getting out of bed in the study group were better than those in the routine group,and the analgesic satisfaction score 48 hours after operation was higher than that in the routine group(P<0.05).The VAS score of the study group was lower than that of the routine group at 24 hours,3,6 and 15 days after operation(P<0.05).There were no significant differences in Bromage scores between the two groups at 12,24,48 h after operation(P>0.05).The incidence of adverse reactions after anesthesia in the study group was lower than that in the routine group(P<0.05).Conclusion:The application of iliac fascia block under ultrasound guidance in elderly hip arthroplasty can effectively reduce the incidence of adverse reactions,achieve better analgesic effect,stabilize heart rate and mean arterial pressure,and enable patients to get out of bed as soon as possible.