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超声引导下持续髂筋膜阻滞在股骨颈骨折手术中的应用效果分析
Application of Ultrasound⁃guided Continuous Fascia Iliaca Block in the Operation for Femoral Neck Fracture

张灵召,王二丽.超声引导下持续髂筋膜阻滞在股骨颈骨折手术中的应用效果分析[J].中国烧伤创疡杂志,2023,35(1):58~61.

DOI：

英文关键词:Femoral neck fracture Fascia iliaca block Laryngeal mask General anesthesia Analgesia Adverse reaction

基金项目:

作者	单位
张灵召	461500 河南许昌, 长葛市人民医院麻醉科
王二丽

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中文摘要:

【摘要】目的探讨超声引导下持续髂筋膜阻滞在股骨颈骨折手术中的应用效果。方法选取 2019 年 4 月至 2021 年 3 月长葛市人民医院收治的 80 例股骨颈骨折患者作为研究对象, 并按照随机数表法将其随机分为观察组 (40 例) 与对照组 (40 例)。观察组患者行超声引导下持续髂筋膜阻滞联合喉罩全身麻醉, 对照组患者单纯行喉罩全身麻醉, 对比观察两组患者心率、平均动脉压、视觉模拟评分法 (VAS) 评分变化情况及不良反应发生情况。结果麻醉诱导 30 min 与术毕时, 两组患者心率及平均动脉压均呈先下降后升高趋势, 但观察组患者变化程度无统计学差异 (F = 2. 010、 0. 863, P = 0. 139、 0. 425), 而对照组患者变化程度较为显著 (F = 22. 271、18. 364, P 均 <0. 001), 且麻醉诱导 30 min 时观察组患者心率及平均动脉压均明显高于对照组 (t = 2. 666、3. 033, P =0. 009、 0. 003), 而术毕时观察组患者心率及平均动脉压均明显低于对照组 (t =2. 588、 2. 242, P =0. 012、 0. 028); 术后 6、 12、 48 h, 两组患者 VAS 评分均逐渐降低 (F = 407. 181、 388. 974, P 均 < 0. 001), 但观察组患者各时间点 VAS 评分均明显低于对照组 (t =5. 355、 5. 589、 7. 140, P 均 <0. 001); 观察组患者术后不良反应发生率为 5. 0%, 与对照组患者的术后不良反应发生率 10. 0% 无明显差异 (χ 2 = 0. 721, P = 0. 396)。结论超声引导下持续髂筋膜阻滞联合喉罩全身麻醉有利于维持股骨颈骨折患者术中血流动力学稳定性, 降低术后疼痛程度。

英文摘要:

【Abstract】 Objective To study the effect of ultrasound?guided continuous fascia iliaca block in the treatment of femoral neck fracture. Methods 80 patients with femoral neck fracture, admitted to Changge People’s Hospital from April 2019 to March 2021, were enrolled as research subjects, and were divided, using the random number table, into observation group (n =40) and control group (n =40). Patients in observation group received ultrasound-guided continuous fascia iliaca block combined with general anesthesia with laryngeal mask airway (LMA), while patients in control group received general anesthesia with LMA alone. The changes of heart rate, mean arterial pressure and visual analogue scale (VAS) scores, and occurrence of adverse reactions were observed and compared between the two groups. Results At 30 min after anesthesia induction and at the end of operation, the heart rate and mean arterial pressure of the patients in the two groupsboth presented a trend of decrease followed by increase, and the difference between the two time points was not statistically significant in observation group (F =2. 010 and 0. 863, P =0. 139 and 0. 425), whereas the difference was statistically significant in control group (F =22. 271 and 18. 364, both P <0. 001). At 30 min of anesthesia induction, the heart rate and mean arterial pressure of patients were significantly higher in observation group compared with control group (t =2. 666 and 3. 033, P =0. 009 and 0. 003), while the two items were both obviously lower in observation group compared with control group at the end of operation (t =2. 588 and 2. 242, P = 0. 012 and 0. 028); at 6, 12 and 48 hours after operation, the VAS scores of patients in both groups all decreased gradually (F = 407. 181, 388. 974, both P < 0. 001), but the VAS scores of patients at the three time points in observation group were all significantly lower compared with that at the responding time points in control group (t = 5. 355, 5. 589 and 7. 140, all P < 0. 001). The incidence of postoperative adverse reactions of patients in observation group was 5. 0%, showing no significant difference as compared with 10. 0% in control group (χ 2 = 0. 721, P = 0. 396). Conclusion Ultrasound?guided continuous fascia iliaca block combined with LMA general anesthesia can help maintain the stability of intraoperative hemodynamics of patients with femoral neck fracture and reduce the degree of postoperative pain.