右美托咪定混合罗哌卡因髂筋膜间隙阻滞用于股骨近端骨折患者术后镇痛的应用效果

Effect of Dexmedetomidine Mixed with Ropivacaine Iliac Fascia Gap Block for Postoperative Analgesia in Patients with Proximal Femoral Fractures

目的评估右美托咪定混合罗哌卡因髂筋膜间隙阻滞用于股骨近端骨折患者术后镇痛的效果。方法选取2020年1月—2021年12月在新沂市人民医院行股骨近端骨折手术的86例患者为研究对象。基于术后镇痛区别分为两组,各43例。对照组予术后静脉镇痛泵镇痛,观察组则予以超声引导下右美托咪定混合罗哌卡因髂筋膜间隙阻滞联合静脉镇痛泵镇痛。比对两组术后不同时段VRS评分、阿片类药物用量及不良反应情况。结果观察组术后6 h、12 h以及24 h VRS疼痛评分分别为(2.03±0.65)分、(1.63±0.46)分、(0.57±0.31)分均低于对照组的(2.89±0.83)分、(2.21±0.65)分、(1.18±0.43)分,差异有统计学意义(t=5.349、4.776、7.546,P<0.05);观察组术后12 h及24 h阿片类药物用量均低于对照组,差异有统计学意义(P<0.001);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论在股骨近端骨折患者术后镇痛处理时使用右美托咪定联合罗哌卡因髂筋膜间隙阻滞的镇痛效果理想。

Objective To evaluate the effect of dexmedetomidine mixed with ropivacaine iliac fascia gap block for postoperative analgesia in patients with proximal femur fractures.Methods 86 patients who underwent proximal femur fracture surgery in the Xinyi People's Hospital during the period from January 2020 to December 2021 were collected.Based on the difference of postoperative analgesia,they were divided into two groups of 43 cases each.The control group was given postoperative intravenous analgesic pump analgesia,while the observation group was given ultrasound-guided dexmedetomidine mixed with ropivacaine iliofascial gap block combined with intravenous analgesic pump analgesia.The VRS scores,opioid doses and adverse effects were compared between the two groups at different postoperative times.Results The VRS scores of the observation group at 6 h,12 h and 24 h after operation were(2.03±0.65)points,(1.63±0.46)points and(0.57±0.31)points lower than those of the control group at(2.89±0.83)points,(2.21±0.65)points and(1.18±0.43)points,and the difference was statistically significant(t=5.349,4.776,7.546,P<0.05).The opioid dosage at 12 h and 24 h postoperatively was lower than that of the control group,and the difference was statistically significant(P<0.001).The incidence of adverse reactions was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The analgesic effect of using dexmedetomidine combined with ropivacaine iliac fascia gap block in the postoperative analgesic management of patients with proximal femur fractures is ideal.