超声引导下前路髂腰肌间隙阻滞与髂筋膜阻滞在老年髋部手术中临床效果的比较

Comparison of the Clinical Effect of Ultrasound-guided Anterior Iliopsoas Space Block and Iliofascial Block in Elderly Hip Surgery

目的比较超声引导下前路髂腰肌间隙阻滞与髂筋膜阻滞在老年髋部手术的效果。方法方便选择2022年1月—2023年1月泰安市中心医院收治的52例全髋关节置换术患者为研究对象,经随机数表法分为A组(下前路髂腰肌间隙阻滞)和B组(髂筋膜阻滞),各26例。对比两组患者静息状态疼痛程度、血流动力学变化情况、神经阻滞操作时间、起效时间、维持时间以及不良反应发生情况。结果T2~T5时,A组视觉模拟评分法(Visual Analogue Scale,VAS)评分显著低于B组,差异有统计学意义(P均<0.05)。A组神经阻滞操作时间、阻滞维持时间高于B组,但神经阻滞起效时间低于B组,差异有统计学意义(P均<0.05)。A组滞后的总不良反应发生率7.69%与B组的15.38%比较,差异无统计学意义(χ^(2)=0.188,P>0.05)。结论相比髂筋膜阻滞,前路髂腰肌间隙阻滞在腰麻下行全髋关节置换术的髋部手术中起效时间相近,在改变体位时镇痛效果更好。

Objective To compare the effect of anterior iliopsoas space block and iliofascial block under ultrasound-guided in elderly hip operation.Methods A total of 52 patients with total hip replacement admitted to Tai'an Central Hospital from January 2022 to January 2023 were conveniently selected as the study objects,and divided into group A(lower anterior iliopsoas space block)and group B(iliofascial block)by random number table method,with 26 cases each.The pain degree of resting state,hemodynamic changes,nerve block operation time,onset time,maintenance time and occurrence of adverse reactions were compared between the two groups.Results At T2~T5,the Visual Analogue Scale(VAS)score of group A were significantly lower than those of group B,and the difference was statistically significant(all P<0.05).The operation time and maintenance time of nerve block in group A were higher than those in group B,but the onset time of nerve block was lower than that in group B,and the difference was statistically significant(all P<0.05).The total incidence of delayed adverse reactions in group A was 7.69%,compared with 15.38%in group B,and the difference was not statistically significant(χ^(2)=0.188,P>0.05).Conclusion Compared with iliac fascia block,anterior iliopsoas space block has a similar onset time in hip surgery for total hip replacement under lumbar anesthesia,and has better analgesic effect when changing position.