髋关节囊周围神经阻滞联合小剂量罗哌卡因腰麻在股骨头置换术中的应用价值
Application Value of Hip Pericapsular Nerve Group Block Combined with Low-dose Ropivacaine Lumbar Anesthesia in Femoral Head Replacement
许军 1段立新 2孙涛3
作者信息
- 1. 100076 北京,北京航天总医院麻醉科
- 2. 102100 北京,北京大学第三医院延庆医院麻醉科
- 3. 273199 山东 曲阜,曲阜市妇幼保健计划生育服务中心
- 折叠
摘要
目的 探讨髋关节囊周围神经阻滞(PNGB)联合小剂量罗哌卡因腰麻在股骨头置换术中的应用价值.方法 选取2019 年 3 月—2022 年 3 月收治的行股骨头置换术者 80 例,按随机数字表法分为观察组和对照组,每组40 例.对照组采用舒芬太尼联合小剂量罗哌卡因腰麻,观察组给予PNGB联合小剂量罗哌卡因腰麻.比较2 组手术时间、腰麻操作时间、体位摆放满意度,首次自控镇痛(PCA)泵按压时间、48h内PCA泵按压次数、实施补救镇痛率,手术前(T0)、摆放体位前(T1)、摆放体位时(T2)、摆放体位后(T3)疼痛情况及不良反应发生率.结果 2 组手术时间比较差异无统计学意义(P＞0.05).与对照组比较,观察组腰麻操作时间缩短,体位摆放满意度升高,首次PCA泵按压时间显著延长,48h内PCA泵按压次数减少,补救镇痛率降低(P＜0.05,P＜0.01).2 组T0 时点视觉模拟评分法(VAS)评分比较差异无统计学意义(P＞0.05).与对照组比较,T1～T3 时点观察组VAS评分降低(P＜0.01).观察组不良反应发生率为22.50%(9/40)低于对照组72.50%(29/40)(P＜0.01).结论 PNGB联合小剂量罗哌卡因腰麻对股骨头置换术患者有显著麻醉效果,能够减轻患者疼痛程度,且不良反应少.
Abstract
Objective To investigate the application value of pericapsular nerve group block(PNGB)combined with low-dose Ropivacaine in femoral head replacement.Methods A total of 80 patients who underwent femoral head replacement from March 2019 to March 2022 were selected and divided into observation group and control group according to random num-ber table method,with 40 cases in each group.The control group was given Sufentanil combined with low-dose Ropivacaine for lumbar anesthesia,and the observation group was given PNGB combined with low-dose Ropivacaine for lumbar anesthesia.The duration of operation,the duration of lumbar anesthesia operation and the satisfaction of body position were compared be-tween the two groups.The first compression time of patient-controlled analgesia(PCA)pump,the number of PCA pump com-pressions within 48 h,and the rate of implementing remedial analgesia,as well as pain before surgery(T0),before placement(T1),during placement(T2),and after placement(T3)and incidence of adverse reactions,were compared between the two groups.Results There was no significant difference in duration of operation between the two groups(P＞0.05).Compared with the control group,the duration of lumbar anesthesia operation in the observation group was shortened,the satisfaction of body position was increased,the first compression time of PCA pump was significantly extended,the number of PCA pump compression was reduced within 48 h,and the rate of relief analgesia was decreased(P＜0.05,P＜0.01).There was no sig-nificant difference in visual analogue scale(VAS)score at T0 between the two groups(P＞0.05).Compared with the control group,the VAS score of the observation group at T1-T3 was decreased(P＜0.01).The incidence of adverse reactions in ob-servation group was22.50%(9/40),which was lower than that in control group72.50%(29/40)(P＜0.01).Conclusion PNGB combined with low-dose Ropivacaine for lumbar anesthesia has a significant anesthetic effect on patients undergoing femoral head replacement,which can reduce the pain degree of patients with fewer adverse reactions.
关键词
髋关节囊周围神经阻滞/小剂量罗哌卡因/腰麻/股骨头/关节成形术,置换,髋/疼痛,手术后/不良反应/麻醉和镇痛Key words
Pericapsular nerve group block/Low-dose ropivacaine/Spinal anesthesia/Femur head/Arthroplasty,replacement,hip/Pain,postoperative/Adverse reaction/Anesthesia and analgesia引用本文复制引用
基金项目
山东省医药卫生科技发展计划项目(2013WS0220)
出版年
2023
国家科技期刊平台
NSTL
万方数据