超声引导下腰方肌阻滞对髋关节置换术患者术后镇痛、炎症及应激反应的影响

Effects of Ultrasound-Guided Lumbar Quadratus Block on Analgesia,Inflammatory Stress,and Immune Function in Patients Undergoing Hip Arthroplasty

目的 探讨超声引导下腰方肌阻滞对髋关节置换术患者术后镇痛、炎症及应激反应的影响。方法 选取2022年1月至2022年12月于河北省唐山市第二医院行髋关节置换术的128例患者为研究对象,以随机数字表法分为全身麻醉组(n=64)和阻滞组(n=64)。比较2组术后疼痛程度、麻醉效果、炎症及应激反应指标[血清白细胞介素6 (IL-6)、C反应蛋白(CRP)、皮质醇(Cor)]及不良反应发生情况。结果 术后疼痛程度、炎症及应激反应指标的组间、时间及交互对比,差异有统计学意义(P <0.05)。2组术后6、12、24 h疼痛视觉模拟评分(VAS),术后1 d、3 d IL-6、CRP、Cor水平均先上升后下降,且阻滞组疼痛VAS评分、术后补救镇痛次数、IL-6、CRP、Cor水平均低于全身麻醉组(P <0.05)。阻滞组不良反应总发生率为9.38%,低于全身麻醉组的23.44%(P <0.05)。结论 超声引导下腰方肌阻滞可有效减轻髋关节置换术后患者的疼痛程度,降低炎症、应激反应水平,麻醉效果及安全性均良好。

Objective To investigate the effect of ultrasound-guided lumbar quadratus block on postoperative analgesia,inflammatory stress,and immune function in patients undergoing hip arthroplasty.Methods 128 patients who underwent hip arthroplasty in our hospital from January 2022 to December 2022 were divided into the general anesthesia group(n=64)and the block group(n=64)using the random number table method.The degree of postoperative pain,anesthetic effect,inflammation and stress reaction indexes[serum interleukin-6(IL-6),C-reactive protein(CRP),cortisol(Cor)],and adverse reactions were compared between the two groups.Results The differences in postoperative pain degree,inflammation and stress response indicators,and immune function indicators between groups,time,and interactions were statistically significant(P<0.05).The VAS scores at 6h,12h,and 24h after surgery,IL-6,CRP,and Cor levels first increased and then decreased,and the VAS scores,the number of postoperative rescue analgesia,and IL-6,CRP,Cor levels in the block group were all lower than those in the general anesthesia group(P<0.05).The total incidence rate of adverse reactions in the block group was 9.38%,which was lower than 23.44%in the general anesthesia group(P<0.05).Conclusion Ultrasound-guided lumbar quadratus block can effectively reduce postoperative pain,inflammation,and stress response levels after hip arthroplasty,with good anesthetic effects and safety.