超声引导下髂筋膜间隙阻滞复合舒芬太尼静脉镇痛对于髋部骨折患者术后镇痛的价值

Value of Ultrasound-guided Iliofascial Space Block Combined with Sufentanil for Postoperative Analgesia in Patients with Hip Fracture

目的:探讨超声引导下髂筋膜间隙阻滞复合舒芬太尼对于髋部骨折患者术后镇痛的作用。方法:选取2019年3月—2022年12月于江苏省句容市中医院进行髋部骨折手术患者46例作为研究对象,按照随机数字表法分为对照组和试验组,各23例。对照组采用舒芬太尼静脉镇痛,试验组采取超声引导下髂筋膜间隙阻滞复合舒芬太尼静脉镇痛。比较两组患者手术前后静息状态下疼痛评分,手术前后24 h的应激反应水平,镇痛后不良反应总发生率以及自控镇痛平均追加次数。结果:术前、术后1 h,两组患者疼痛评分比较,差异无统计学意义(P>0.05);术后12 h与24 h,试验组患者疼痛评分低于对照组,差异有统计学意义(P<0.001)。术前,两组患者皮质醇水平、血管紧张素Ⅱ水平比较,差异无统计学意义(P>0.05);术后24 h,试验组患者皮质醇、血管紧张素Ⅱ水平低于对照组,差异有统计学意义(P<0.001)。试验组患者自控镇痛追加次数、不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论:超声引导下髂筋膜间隙阻滞复合舒芬太尼静脉镇痛可更好地缓解髋部骨折患者的术后疼痛感,对患者手术后恢复有积极作用。

Objective:To investigate the effect of ultrasound-guided iliofascial space block combined with sufentanil on postoperative analgesia in patients with hip fracture.Methods:A total of forty-six patients who underwent hip fracture surgery in Jurong Hospital of Traditional Chinese Medicine from March 2019 to December 2022 were selected as the study objects,and were divided into control group and experimental group according to random number table method,with twenty-three cases in each group.The control group was given sufentanil intravenous analgesia,and the experimental group was given sufentanil intravenous analgesia combined with iliofascial space block under ultrasound-guided.The score of pain at rest,the level of stress response 24 h before and after surgery,the total incidence of adverse reactions after analgesia and the average number of additional controlled analgesia were compared between the two groups.Results:There was no significant difference in pain scores between the two groups before and 1 h after surgery(P>0.05).After 12 h and 24 h,the pain score of experimental group was lower than that of control group,and the difference was statistically significant(P<0.001).Before operation,there was no significant difference in the levels of cortisol and angiotensin Ⅱ between 2 groups(P>0.05).24 h after operation,the levels of cortisol and angiotensin Ⅱ in experimental group were lower than those in control group,and the difference was statistically significant(P<0.001).The additional times of controlled analgesia and the total incidence of adverse reactions in experimental group were lower than those in control group,and the difference was statistically significant(P<0.05).Conclusion:Ultrasound-guided iliofascial space block combined with sufentanil intravenous analgesia can better relieve postoperative pain in patients with hip fracture,and has a positive effect on postoperative recovery of patients.