超声引导髂筋膜间隙阻滞在髋关节镜手术中的应用

发布时间：2018-06-27 02:59

本文选题：超声引导 + 髂筋膜间隙阻滞　；参考：《中国微创外科杂志》2017年10期

【摘要】：目的探讨超声引导髂筋膜间隙阻滞在髋关节镜手术中的应用效果。方法 2016年10月~2017年2月择期髋关节镜手术40例,随机分为阻滞组和对照组各20例。均行全凭静脉麻醉,喉罩通气。阻滞组全麻后在超声引导下行髂筋膜间隙阻滞(0.5%罗哌卡因30 ml),随后手术;对照组直接在全麻下手术。术中均维持脑电双频指数40~55。记录术中舒芬太尼用量,术后离麻醉恢复室静息疼痛视觉模拟评分(visual analogue scale,VAS),术后4、8、12、24 h静息和术后4、24 h运动(屈曲、内旋、外旋)疼痛VAS,以及术后24 h静脉患者自控镇痛(patient controlled analgesia,PCA)药物用量。结果阻滞组术中舒芬太尼用量[(17.0±5.7)μg vs.(24.5±8.4)μg,t=-3.308,P=0.002]、术后24 h PCA用量[(48.1±2.6)ml vs.(52.4±2.8)ml,t=-4.909,P=0.000]均明显少于对照组;阻滞组离麻醉恢复室及术后4、8、12、24 h静息疼痛VAS及术后4 h运动疼痛VAS明显低于对照组(P0.05)。结论超声引导下髂筋膜间隙阻滞可为髋关节镜手术提供良好术中及术后镇痛。
[Abstract]:Objective to investigate the effect of ultrasound-guided iliac fascial space block in hip arthroscopy. Methods from October 2016 to February 2017, 40 patients were randomly divided into block group (n = 20) and control group (n = 20). All patients underwent total intravenous anesthesia and laryngeal mask ventilation. The iliac fascial space block (0.5% ropivacaine 30 ml),) was performed in the block group after general anesthesia, while the control group was operated directly under general anesthesia. The bispectral index of EEG was 40 ~ 55. The dosage of sufentanil during the operation, the visual analogue score (visual analogue scale) of postoperative rest pain after anesthesia recovery, the rest 24 h after operation and the exercise (flexion, internal rotation) were recorded. The dosage of (patient controlled analgesia (patient controlled analgesia) 24 hours after operation. Results the dosage of sufentanil in the anesthesia group [(17.0 卤5.7) 渭 g vs. (24.5 卤8.4 渭 g / min -3.308 渭 g vs. (0.002] and 24 hours after operation [(48.1 卤2.6) ml vs. (52.4 卤2.8) ml fentanyl 0.000] were significantly lower than those in the control group, and the VAS in the block group was significantly lower than that in the control group (P 0.05). Conclusion Ultrasound-guided iliac fascial space block can provide good intraoperative and postoperative analgesia for hip arthroscopy.
【作者单位】：北京积水潭医院麻醉科;
【基金】：北京市科学技术委员会首都临床特色应用研究(课题编号:Z131107002213125)
【分类号】：R614

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