B超引导下的髂筋膜间隙阻滞对髋部手术术后的镇痛效果

Effect of B-ultrasound guided fascia iliaca compartment block on postoperative analgesia in patients undergoing hip surgery

目的:评估B超引导下的髂筋膜间隙阻滞(简称髂筋膜阻滞)联合罗哌卡因单侧腰麻在髋部手术术后的镇痛效果。方法:收集合肥市骨科医院2019年1月~2020年12月行髋部手术的180例患者并随机分为对照组和观察组,每组90例。对照组行罗哌卡因单侧腰麻,观察组行B超引导下髂筋膜阻滞联合罗哌卡因单侧腰麻。评估两组术前术后疼痛程度[静息时视觉模拟评分法(rVAS)和活动时视觉模拟评分法(eVAS)]、肌力(Bromage评分)、炎症因子[白细胞介素-6(IL-6)、降钙素原(PCT)及C反应蛋白(CRP)]及凝血功能[D-二聚体(D-D)]、术后感觉恢复及运动恢复时间、补救镇痛、首次下床时间及不良反应。结果:与对照组比,观察组术后的rVAS评分、eVAS评分、Bromage评分、D-D水平均降低(P<0.05),术后感觉和运动恢复时间、补救镇痛、首次下床时间及不良反应均降低(P<0.05)。结论:B超引导下髂筋膜间隙阻滞可提升髋部手术术后的镇痛效果,降低炎症因子,改善凝血功能,减少不良反应。

Objective:To evaluate the effect of B-ultrasound guided fascia iliaca compartment block on postoperative analgesia in patients undergoing hip surgery.Methods:A total of 180 patients undergoing hip surgery in our hospital between January 2019 and August 2020 were included,and randomly divided into control group and observation group,with 90 cases in each group.The control group received unilateral spinal anesthesia with ropivacaine,while the observation group were given unilateral spinal anesthesia with ropivacaine combined with ultrasound guided fascia iliaca compartment block.Then the two groups were compared regarding preoperative and postoperative pain degree[rest/exercise visual analogue scale(rVAS/eVAS)scores],muscle strength(Bromage score),inflammatory factors[interleukin-6(IL-6),calcitonin(PCT)and C-reactive protein(CRP)],coagulation function(D-dimer,D-D),postoperative sensory and motor recovery time,remedial analgesia,initial off-bed and adverse reaction.Results:Compared with the control group,postoperative rVAS,eVAS,Bromage scores and D-D levels as well as postoperative sensory and motor recovery time,remedial analgesia,initial off-bed and adverse reaction were decreased in the observation group(all P<0.05).Conclusion:B-ultrasound guided fascia iliaca compartment block can improve the analgesic effect after hip surgery,reduce inflammatory factors,improve coagulation function and decrease adverse reactions.