| 刘友明,郭 强,赵 洁.超声引导下腰方肌阻滞在全髋关节置换患者中的应用效果分析[J].中国烧伤创疡杂志,2023,(4):302~305. |
| DOI： |
| 中文关键词: 腰方肌阻滞 超声引导 全髋关节置换 镇痛 麻醉 |
| 英文关键词:Quadratus lumborum block Ultrasound-guided Total hip replacement Analgesia Anesthesia |
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| 中文摘要: |
| 【摘要】 目的 分析超声引导下腰方肌阻滞在全髋关节置换患者中的应用效果。方法 选取 2019 年 1 月至2021 年 3 月河南省洛阳正骨医院收治的 100 例拟行全髋关节置换术的髋关节疾病患者作为研究对象, 按照随机数表法将其随机分为观察组 (50 例) 和对照组 (50 例), 观察组患者术中采用超声引导下腰方肌阻滞联合全身麻醉、术后行腰方肌阻滞外导管连接自控镇痛泵自控镇痛, 对照组患者术中单纯采用全身麻醉、术后行静脉留置针连接自控镇痛泵自控镇痛, 对比观察两组患者手术时间、术中出血量、麻醉起效时间、麻醉维持时间以及术后静息和活动时的疼痛程度。结果 观察组患者手术时间及术中出血量与对照组无明显差异 (t =0.377、0.375, P =0.707、0.709), 麻醉起效时间明显短于对照组 (t = 17.320, P < 0.001), 麻醉维持时间明显长于对照组 (t =10.080, P <0.001)。术后 4、8、12、24 h, 观察组患者静息和活动时数字分级评分法 (NRS) 评分均明显低于对照组 (静息时: t =2.116、4.698、2.418、2.296, P = 0.037、P < 0.001、P = 0.017、P = 0.024; 活动时: t =2.590、2.500、4.892、2.346, P =0.011、P <0.001、P < 0.001、P = 0.021)。结论 超声引导下腰方肌阻滞可有效缩短麻醉起效时间, 延长麻醉维持时间, 降低全髋关节置换术后疼痛程度。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the application effect of ultrasound-guided quadratus lumborum block in total hip replacement. Methods 100 patients with hip disorders who admitted into Luoyang Orthopedic-Traumatological Hospital of Henan Province for total hip replacement between January 2019 and March 2021 were enrolled as research subjects, and then divided into study group (n =50) and control group (n =50) using the random number table. Patients in the study group were given ultrasound-guided quadratus lumborum block plus the general anesthesia, and after operation the external catheter of quadratus lumborum block was connected to self-controlled analgesia pump for self-controlled analgesia, while patients in the control group were given the general anesthesia alone, and after operation the venous indwelling catheter was connected to self-controlled analgesia pump for self-controlled analgesia. The operation time, intraoperative blood loss, onset time and maintenance time of anesthesia, and postoperative pain degree of patients during resting and activity status were compared between the two groups. Results There were no statistically significant differences between the two groups in terms of operation time and intraoperative blood loss (t =0.377 and 0.375, P =0.707 and 0.709), and the onset time of anesthesia in the study group was obviously shorter (t =17.320, P <0.001), and the maintenance time of anesthesia was markedly longer (t =10.080, P <0.001) compared with the control group. Respectively at 4 h, 8 h, 12 h and 24 h after operation, the scores of numerical rating scale (NRS) of patients during resting and activity status in the study group were all markedly lower than that in the control group (during resting: t = 2.116, 4.698, 2.418 and 2.296, P = 0.037, P < 0.001, P =0.017, P =0.024; during activity: t =2.590, 2.500, 4.892 and 2.346, P =0.011, P <0.001, P <0.001,P =0.021). Conclusion The ultrasound-guided quadratus lumborum block can effectively shorten the onset time of anesthesia, maintain a long anesthetic status and decrease patients’ pain after total hip replacement. |
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