超声引导下腹股沟韧带上髂筋膜阻滞在老年髋关节置换术全身麻醉患者中的应用效果及对安全性的影响

Application effect and safety of ultrasound-guided supraguinal iliofascial block in elderly patients undergoing general anesthesia for total hip replacement

目的探讨超声引导下腹股沟韧带上髂筋膜阻滞老年髋关节置换术全身麻醉患者中的应用效果及对治疗安全性的影响。方法选取2022年1月至2022年10月于淮安市第五人民医院行老年髋关节置换术的80例患者作为研究对象,采用随机数字表法分为观察组与对照组,每组40例。对照组行常规全身麻醉,观察组在常规全身麻醉基础上实施超声引导下行腹股沟韧带上髂筋膜阻滞。比较两组手术相关指标、疼痛情况、镇痛药物使用量及不良反应发生情况。结果两组手术时间与术中失血量比较差异无统计学意义;观察组自主活动恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。术后第1、2天,观察组休息时、活动时视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05)。观察组术中瑞芬太尼使用量、麻醉后监护室与术后48 h芬太尼使用量均少于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为5.00%,低于对照组的37.5%,差异有统计学意义(P<0.05)。结论对行老年髋关节置换术全身麻醉的患者实施超声引导下腹股沟韧带上髂筋膜阻滞,有利于缓解患者术后疼痛,减少镇痛药物使用量,且安全性较高。

Objective To investigate the efficacy and safety of ultrasound-guided supringuinal iliacfascia block in elderly patients undergoing general anesthesia for total hip replacement.Methods A total of 80 elderly patients undergoing total hip replacement in the Fifth People's Hospital of Huai'an City from January 2022 to October 2022 were selected as the study subjects,and they were divided into the observation group and the control group by random number table method,with 40 cases in each group.The control group received conventional general anesthesia,and the observation group received ultrasound-guided iliacfascia block on the basis of conventional general anesthesia.Operation related indexes,pain,analgesic drug use and adverse reactions were compared between the two groups.Results There was no significant difference in operation time and intraoperative blood loss between the two groups;the recovery time and hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).On the first and second days after surgery,the visual analog scale(VAS)scores at rest and activity in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The amount of remifentanil used during operation,the amount of fentanyl used in the ICU after anesthesia and 48 h after surgery in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 5.00%,which was lower than 37.5%in the control group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided supringuinal iliofascial block in elderly patients undergoing general anesthesia for total hip replacement is beneficial to relieve postoperative pain,reduce the use of analgesic drugs,and has high safety.