股神经阻滞麻醉联合局部浸润麻醉在老年髋关节置换手术中的应用

目的:探究股神经阻滞麻醉联合伤口局部浸润麻醉对老年髋关节置换术后疼痛程度的影响。方法:选择2016年1月~2018年6月我院收治的髋关节置换术的85例患者,据患者入院的编号的奇偶随机分为两组。对照组的42例采用伤口浸润麻醉方法,观察组的43例采用股神经阻滞麻醉联合伤口浸润麻醉方法。比较两组的麻醉效果、镇痛效果、术后阿片类药物的使用情况、住院时间及下床活动时间。结果:观察组感觉阻滞时间、恢复痛觉时间均显著长于对照组(P<0.05),术后12 h的视觉模拟评分法(Visual analog scales,VAS)评分较对照组明显降低(P<0.05),但两组术后6 h和1 d的VAS评分无统计学差异(P>0.05);观察组术后1 d的阿片类药物使用剂量较对照组明显降低(P<0.05),但两组术后2 d的阿片类药物使用剂量比较无统计学差异(P>0.05),观察组住院时间及下床活动时间较对照组明显缩短(P<0.05)。结论:股神经阻滞联合伤口浸润麻醉对于进行髋关节置换术的老年患者具有较好的镇痛效果,且在手术后阿片类镇痛药物的使用剂量减少,住院时间和下床活动时间均有所改善。

Application of Femoral Nerve Block Anesthesia Combined with Local Infiltration Anesthesia for the Elderly Patients with Hip Replacement Surgery

ABSTRACT Objective: To investigate the effect of femoral nerve block anesthesia combined with local infiltration anesthesia for the elderly patients with hip replacement surgery. Methods: Eighty-five patients who admitted to our hospital from January 2016 to June 2018 and underwent hip arthroplasty were randomly divided into the two groups according to the parity of the number. 42 patients in the control group underwent local infiltration anesthesia, and 43 patients in the observation group were treated with femoral nerve block anesthesia combined with local infiltration anesthesia. The anesthetic effect, analgesic effect, postoperative opioid use, hospital stay and time of getting out of bed were compared between tw groups. Results: The sensory block time and recovery pain time were significantly longer in the observation group than in the control group (P<0.05). The VAS scores was significantly lower in the observation group at 12 h after operation(P<0.05), but there was no significant difference between the two groups at 6 h and 1 d(P>0.05). The dose of opioids in the observation group was significantly lower than that in the control group at 1 day after operation (P<0.05), but there was no significant difference between the two groups at 2 day after operation (P>0.05). The time of hospital stay and the time of getting out of bed were significantly shorter than that of the control group (P<0.05). Conclusion: Femoral nerve block combined with local infiltration anesthesia has a good analgesic effect on the elderly patients undergoing hip replacement surgery, and the dose of opioid analgesics is reduced after surgery, the hospitalization time and time to get out of bed are improved.