目的 探索超声引导腹股沟韧带上髂筋膜阻滞(S-FICB)对大腿止血带引起的缺血再灌注损伤的作用。方法 纳入2022年2月至2023年3月在永康市第一人民医院全身麻醉下择期行单侧膝关节镜手术患者73例，按随机信封法分为试验组(36例)和对照组(37例)。试验组患者行S-FICB，对照组患者不进行神经阻滞操作。2组患者均行气管插管全身麻醉。记录2组患者入室后(T0)、止血带充气前即刻(T1)、充气后20 min(T2)、充气后40 min(T3)、充气后60 min(T4)、充气后80 min(T5)、止血带释放即刻(T6)、释放5 min(T7)的有创平均动脉压、心率、麻醉药物用量，记录总出血量、输液量、止血带相关高血压发生次数及镇痛药物使用量。测量2组患者T1、止血带释放后1 min、止血带释放后30 min的肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、丙二醛水平。记录2组患者不同时间数字疼痛评分表(NRS)评分、并发症发生情况。结果 与对照组比较，试验组患者在T4、T5时刻平均动脉压显著降低，止血带释放后1 min、释放后30 min TNF-α、丙二醛水平显著降低，拔管后30 min、术后24 h NRS评分显著降低，止血带相关高血压发生率降低，氟比洛芬酯使用量减少，差异均有统计学有意义(P＜0。05)。2组患者均未出现常见并发症。结论 S-FICB可减少大腿止血带引起的缺血再灌注损伤，降低止血带相关高血压发生率，减少术后镇痛药物使用。
Effect of ultrasound-guided superior fascia iliaca compartment block of the inguinal ligament to reduce ischaemic reperfusion injury induced by the use of thigh tourniquets
Objective To explore the effect of ultrasound-guided superior fascia iliaca compartment block(S-FICB)of the inguinal ligament on ischaemic reperfusion injury induced by the use of a thigh tourni-quet.Methods A total of 73 cases of unilateral knee arthroscopic surgery under general anaesthesia in the Yongkang First People's Hospital from February 2022 to March 2023 were included and divided into the ex-perimental group(36 cases)and the control group(37 cases)according to random envelope method.The ex-perimental group underwent S-FICB and the control group did not undergo nerve block.Both groups under-went general anesthesia with tracheal intubation.The invasive mean arterial pressure,heart rate and anesthetic drug dosage were recorded of the two groups immediately after admission(T0),immediately before tourniquet inflation(T1),20 min(T2),40 min(T3),60 min(T4),80 min(T5)after tourniquet inflation,immediately tourniquet release(T6)and 5 min(T7)after tourniquet release were recorded.The total blood loss,infusion volume,tourniquet related hypertension frequency and analgesic use were recorded.Tumor necrosis factor-α(TNF-α),interleukin 6(IL-6)malondialdehyde(MDA)levels were measured at T1,one minute after tourni-quet release and 30 min after tourniquet release.The occurrence of complications on the digital numerical rat-ing scale(NRS)was recorded in the two groups at different time.Results Compared with the control group,the mean arterial pressure at T4 and T5,TNF-α and MDA at 1min and 30 min after tourniquet release,NRS score at 30 min after extubation and 24 h after operation,tourniquet related hypertension and flurbiprofen ax-etil consumption were significantly reduced in the observation group,the differences were statistically signifi-cant(P＜0.05).Conclusion S-FICB can reduce the ischemia reperfusion injury caused by tourniquet in lower limbs,reduce the incidence of tourniquet related hypertension,and reduce the use of postoperative analgesic drugs.
Fascia iliaca compartment blockIschemia reperfusion injuryUltrasonographyTourniquetThigh
万方数据
维普
