中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2011年
10期
1175-1177
,共3页
魏长娜%王琛%单海华%谢红
魏長娜%王琛%單海華%謝紅
위장나%왕침%단해화%사홍
筋膜%神经传导阻滞%超声检查,介入性%关节成形术,置换,髋%镇痛
觔膜%神經傳導阻滯%超聲檢查,介入性%關節成形術,置換,髖%鎮痛
근막%신경전도조체%초성검사,개입성%관절성형술,치환,관%진통
Fascia%Nerve block%Ultrasonography%Arthroplasty,hip,replacement%Analgesia
目的 评价超声引导下髂筋膜腔隙阻滞对全髋关节置换术患者术后镇痛的效果.方法 择期行全髋关节置换术患者36例,年龄54～82岁,体重48～72 kg,ASA分级Ⅰ～Ⅲ级,采用随机数字表法,将其随机分为2组(n=18):生理盐水组(NS组)和罗哌卡因组(R组).手术结束后30 min内行患侧超声引导下髂筋膜腔隙阻滞.R组髂筋膜腔隙注射0.25％罗哌卡因30 ml；NS组注射等容量生理盐水.阻滞完成后,采用0.01 mg/ml芬太尼行PCIA,无背景输注,PCA量2ml,锁定时间15 min.于阻滞前即刻(T0)、阻滞后3 h(T1)、6 h(T2)、8 h(T3)、12 h(T4)、24 h(T5)、48 h(T6)和72 h(T7)时,记录静态VAS评分；于T4、T5、T6和T7时,记录被动运动VAS评分；于T5、T6和T7时,记录主动运动VAS评分.记录阻滞后0～12h、12～24 h、24～48 h、48～ 72 h各时段内芬太尼用量.记录术后不良反应的发生情况.结果 与NS组比较,R组T1～T7时静态VAS评分、T4～T7时被动运动VAS评分和T5～T7时主动运动VAS评分均降低,各时段芬太尼用量减少(P＜0.05).两组不良反应发生率差异无统计学意义(P＞0.05).结论 全髋关节置换术患者超声引导下髂筋膜腔隙阻滞的镇痛效果好,安全性良好.
目的 評價超聲引導下髂觔膜腔隙阻滯對全髖關節置換術患者術後鎮痛的效果.方法 擇期行全髖關節置換術患者36例,年齡54～82歲,體重48～72 kg,ASA分級Ⅰ～Ⅲ級,採用隨機數字錶法,將其隨機分為2組(n=18):生理鹽水組(NS組)和囉哌卡因組(R組).手術結束後30 min內行患側超聲引導下髂觔膜腔隙阻滯.R組髂觔膜腔隙註射0.25％囉哌卡因30 ml；NS組註射等容量生理鹽水.阻滯完成後,採用0.01 mg/ml芬太尼行PCIA,無揹景輸註,PCA量2ml,鎖定時間15 min.于阻滯前即刻(T0)、阻滯後3 h(T1)、6 h(T2)、8 h(T3)、12 h(T4)、24 h(T5)、48 h(T6)和72 h(T7)時,記錄靜態VAS評分；于T4、T5、T6和T7時,記錄被動運動VAS評分；于T5、T6和T7時,記錄主動運動VAS評分.記錄阻滯後0～12h、12～24 h、24～48 h、48～ 72 h各時段內芬太尼用量.記錄術後不良反應的髮生情況.結果 與NS組比較,R組T1～T7時靜態VAS評分、T4～T7時被動運動VAS評分和T5～T7時主動運動VAS評分均降低,各時段芬太尼用量減少(P＜0.05).兩組不良反應髮生率差異無統計學意義(P＞0.05).結論 全髖關節置換術患者超聲引導下髂觔膜腔隙阻滯的鎮痛效果好,安全性良好.
목적 평개초성인도하가근막강극조체대전관관절치환술환자술후진통적효과.방법 택기행전관관절치환술환자36례,년령54～82세,체중48～72 kg,ASA분급Ⅰ～Ⅲ급,채용수궤수자표법,장기수궤분위2조(n=18):생리염수조(NS조)화라고잡인조(R조).수술결속후30 min내행환측초성인도하가근막강극조체.R조가근막강극주사0.25％라고잡인30 ml；NS조주사등용량생리염수.조체완성후,채용0.01 mg/ml분태니행PCIA,무배경수주,PCA량2ml,쇄정시간15 min.우조체전즉각(T0)、조체후3 h(T1)、6 h(T2)、8 h(T3)、12 h(T4)、24 h(T5)、48 h(T6)화72 h(T7)시,기록정태VAS평분；우T4、T5、T6화T7시,기록피동운동VAS평분；우T5、T6화T7시,기록주동운동VAS평분.기록조체후0～12h、12～24 h、24～48 h、48～ 72 h각시단내분태니용량.기록술후불량반응적발생정황.결과 여NS조비교,R조T1～T7시정태VAS평분、T4～T7시피동운동VAS평분화T5～T7시주동운동VAS평분균강저,각시단분태니용량감소(P＜0.05).량조불량반응발생솔차이무통계학의의(P＞0.05).결론 전관관절치환술환자초성인도하가근막강극조체적진통효과호,안전성량호.
Objective To investigate the efficacy of ultrasound-guided fascia iliaca compartment block (FICB) on postoperative analgesia in patients undergoing total hip arthroplasty.Methods Thirty-six ASA Ⅰ-Ⅲ patients aged 54-82 yr weighing 48-72 kg undergoing total hip arthroplasty were randomly divided into 2 groups (n =18 each): normal saline group(group NS)and ropivacaine group (group R).Ultrasound-guided FICB was performed within 30 min after operation.Group R received 0.25 ％ ropivacaine 30 ml,while the equal volume of normal saline was used instead of ropivacaine in group NS.All patients received PCIA with 0.01 mg/ml fentanyl after FICB.PCIA included a bolus dose of 2 ml with a 15 min lockout interval and no background infusion.Pain at rest was evaluated using VAS (RVAS) score before FICB (T0 ）and at 3 h(T1 ),6 h(T2 ),8 h(T3 ),12 h(T4 ),24 h(T5 ),48 h(T6 )and 72 h(T7 )after FICB.The passive exercise VAS (PVAS) score at T4-6,T7 and active exercise VAS (AVAS) score at T5-7 were recorded.The consumption of fentanyl at 0-12 h,12-24 h、24-48 h and 48-72 h after FICB and the adverse effects were also recorded.Results Compared with group NS,RVAS score,PVAS score,AVAS score and the consumption of fentanyl were significantly decreased in group R.There was no significant difference in the adverse effects between the two groups.Conclusion Ultrasound-guided FICB can provide better postoperative analgesia with little adverse effects in patients undergoing total hip arthroplasty.
