超声引导下高位髂筋膜阻滞在老年全髋关节置换术患者中的应用效果

Application effect of ultrasound-guided high fascia iliaca block in elderly patients with total hip arthroplasty

目的探究超声引导下高位髂筋膜阻滞在老年全髋关节置换术患者中的应用效果。方法选取2019年3月至2021年3月于本院接受全髋关节置换术的60例老年患者作为研究对象,按照随机数字表法分为两组,每组30例。对照组接受单纯全身麻醉,观察组接受超声引导下高位髂筋膜阻滞复合全身麻醉,比较两组术中麻醉药使用量、疼痛程度、康复情况。结果观察组丙泊酚用量、瑞芬太尼用量均少于对照组,差异有统计学意义(P<0.05)。两组视觉模拟评分法(VAS)评分组间、时点、交互比较差异有统计学意义(P<0.05);术后4、8、12、24 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。观察组术后睁眼时间、拔管时间、下床活动时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论超声引导下高位髂筋膜阻滞应用于老年全髋关节置换术患者中效果显著,可减少术中麻醉药物使用量,降低术后疼痛程度,加快术后康复,具有较高的应用价值。

Objective To explore the application effect of ultrasound-guided high fascia iliaca block in elderly patients with total hip arthroplasty.Methods 60 elderly patients who underwent total hip arthroplasty in our hospital from March 2019 to March 2021 were selected as the research subjects,and they were divided into two groups according to the random number table method,with 30 cases in each group.The control group received simple general anesthesia,and the observation group received ultrasound-guided high fascia iliaca block combined with general anesthesia,the amount of anesthesia used,the degree of pain,and the rehabilitation situation between the two groups were compared.Results The dosage of propofol and remifentanil in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were significant differences in visual analogue scale(VAS)scores between the two groups,point of time,interaction(P<0.05);at 4,8,12,and 24 h after operation,the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The time of eye opening,time of extubation,time of getting out of bed,and hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The application of ultrasound-guided high fascia iliaca block has a significant effect in elderly patients undergoing total hip arthroplasty,can reduce the dosage of intraoperative anesthetics,reduce the degree of postoperative pain,and speed up postoperative recovery,which has high application value.