超声引导下髂筋膜神经阻滞联合腰麻在老年股骨颈骨折患者行髋关节置换术中的应用价值

Application Value of Ultrasound-guided Iliofascial Nerve Block Combined with Lumbar Anesthesia in Elderly Patients with Femoral Neck Fracture Undergoing Hip Replacement

目的探讨超声下髂筋膜神经阻滞联合腰麻在老年股骨颈骨折患者行髋关节置换术中的应用效果。方法选取2021年1月—2023年5月徐州市矿山医院收治的80例老年股骨颈骨折行髋关节置换术患者为研究对象,按照随机数表法分两组,各40例。对照组给予常规腰椎布比卡因麻醉,观察组先给予超声引导下髂筋膜神经阻滞,再予腰椎麻醉。比较两组麻醉效果、疼痛评分、平均动脉压、心率及麻醉并发症的发生率。结果观察组的麻醉效果优于对照组,差异有统计学意义(P<0.05);观察组疼痛评分在手术过程中及术后4、12 h均低于对照组,差异有统计学意义(P均<0.05);术后24 h观察组疼痛评分低于对照组,差异无统计学意义(P>0.05)。术中和术毕阶段观察组血压及心率均高于对照组,差异有统计学意义(P均<0.05)。观察组术后麻醉并发症总发生率为12.50%,显著低于对照组的30.00%,差异有统计学意义(χ^(2)=4.588,P<0.05)。结论超声下髂筋膜神经阻滞联合腰麻在老年股骨颈骨折行髋关节置换术中的麻醉效果更好。

Objective To investigate the application effect of ultrasound-guided iliofascial nerve block combined with lumbar anesthesia in elderly patients with femoral neck fracture undergoing hip replacement.Methods A total of 80 patients with femoral neck fracture undergoing hip replacement in Xuzhou Mining Hospital from January 2021 to May 2023 were selected as the research objects and divided into two groups according to random number table method,with 40 patients in each group.The control group was given conventional lumbar bupivacaine anesthesia,and the observation group was given ultrasound-guided iliofascial nerve block and then lumbar anesthesia.Anesthesia effect,pain score,mean arterial pressure,heart rate and incidence of anesthesia complications were compared between the two groups.Results The anesthetic effect of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).The pain scores of the observation group were lower than those of the control group during the operation and 4 and 12 h after the operation,and the differences were statistically significant(all P<0.05).24 h after operation,the pain score of observation group was lower than that of control group,and the difference was not statistically significant(P>0.05).The blood pressure and heart rate of the observation group were higher than those of the control group during and after operation,and the differences were statistically significant(both P<0.05).The total incidence of postoperative anesthesia complications in the observation group was 12.50%,significantly lower than that in the control group(30.00%),and the difference was statistically significant(χ^(2)=4.588,P<0.05).Conclusion The effect of ultrasound-guided iliofascial nerve block combined with lumbar anesthesia is better in elderly patients undergoing hip replacement with femoral neck fracture.