不同电流强度引导下连续腰丛阻滞对全髋置换术后镇痛效果的比较

发布时间：2018-04-30 04:05

本文选题：连续腰丛神经阻滞 + 电流强度　；参考：《延边大学》2017年硕士论文

【摘要】：目的分析不同的电流强度行连续腰丛神经阻滞对人工髋关节置换术后的镇痛效果。方法选择全麻下行人工髋关节置换手术的患者120例(ASA Ⅰ～Ⅲ级),随机分为四组(n=30):A组舒芬太尼静脉镇痛泵组,N组选用神经刺激器行连续腰丛神经阻滞,N1组选择的电流强度为0.1～0.5mA,N2组选择0.6～1.0m,N3组选择1.1～2.0mA。四组患者均行静吸复合全身麻醉行气管插管。N组患者全麻诱导前行连续腰丛神经阻滞,通过留置导管自控泵入0.2%罗哌卡因,A组患者术后静脉给予舒芬太尼自控镇痛,四组患者均维持镇痛48小时。分别记录各组患者术后不同时间点静息VAS疼痛评分(RVAS)和主动活动的VAS疼痛评分(IVAS)、自控键按键次数、患者总体满意度及不良反应。结果N1组与N2组术后RVAS和IVAS评分无统计学差异,N3组RVAS和IVAS评分明显高于N1组和N2组(p0.05),A组RVAS和IVAS评分明显高于N1、N2组(p0.05);N1组与N2组自控键48h按键次数无统计学差异,N3组自控键 48h 按键次数(3.90 ± 0.96)明显高于 N1 组(1.93 土 0.98)和 N2 组(2.06 ± 0.98)(p0.01);四组患者的总体满意度较高;N1-N3组恶心、呕吐、瘙痒、镇静过度等不良反应均无明显统计学差异,不良反应A组明显多于N1-N3组(p0.05)。结论选用0.6～1.0mA电流强度下行连续腰丛神经阻滞用于人工髋关节置换术后自控镇痛可达到满意效果,且镇痛效果优于静脉自控镇痛,减少术后不良反应。
[Abstract]:Objective to analyze the analgesic effect of continuous lumbar plexus block with different electric current intensity after hip arthroplasty. Methods one hundred and twenty patients undergoing artificial hip replacement under general anesthesia were randomly divided into four groups: sufentanil intravenous analgesia pump group (n = 40) and continuous lumbar plexus block group N (n = 1). The flow intensity was 0.1 ~ 0.5mAN _ 2 group and 0.6 ~ 1.0mN _ 3 group was chosen, and the flow intensity was 1.1 ~ 2.0mA. All the patients in the four groups were treated with intravenous inhalation combined with general anesthesia. The patients in group N received continuous lumbar plexus nerve block before induction under general anesthesia. Sufentanil was administered intravenously to patients in group A by self-controlled infusion of 0.2% ropivacaine via indwelling catheter. Analgesia was maintained for 48 hours in all the four groups. The rest VAS pain score and active activity VAS pain score were recorded at different time points after operation, the number of keystrokes, the patients' overall satisfaction and adverse reactions were recorded. Results there was no significant difference in RVAS and IVAS scores between N1 group and N2 group. The scores of RVAS and IVAS in N3 group were significantly higher than those in N1 group and N2 group. The scores of RVAS and IVAS in group N _ 1 and N _ 2 group were significantly higher than those in group N _ 1N _ 2 group and N _ 2 group. The number of keys in 48 hours was 3.90 卤0.96), which was significantly higher than that in N1 group (1.93 卤0.98) and N2 group (2.06 卤0.98) p0.01.The overall satisfaction of the four groups was higher than that of N1-N3 group. There was no significant difference in adverse reactions such as vomiting, pruritus and excessive sedation. The adverse reactions in group A were significantly higher than those in group N1-N3 (P 0.05). Conclusion continuous lumbar plexus block with 0.6~1.0mA electric current intensity can achieve satisfactory analgesia effect after artificial hip arthroplasty, and the analgesic effect is better than that of intravenous analgesia, which can reduce the adverse reaction after operation.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R614

【相似文献】