本文選題：超聲引導(dǎo) + 髂筋膜間隙阻滯　； 參考：《中國微創(chuàng)外科雜志》2017年10期

【摘要】：目的探討超聲引導(dǎo)髂筋膜間隙阻滯在髖關(guān)節(jié)鏡手術(shù)中的應(yīng)用效果。方法 2016年10月~2017年2月?lián)衿隗y關(guān)節(jié)鏡手術(shù)40例,隨機(jī)分為阻滯組和對(duì)照組各20例。均行全憑靜脈麻醉,喉罩通氣。阻滯組全麻后在超聲引導(dǎo)下行髂筋膜間隙阻滯(0.5%羅哌卡因30 ml),隨后手術(shù);對(duì)照組直接在全麻下手術(shù)。術(shù)中均維持腦電雙頻指數(shù)40~55。記錄術(shù)中舒芬太尼用量,術(shù)后離麻醉恢復(fù)室靜息疼痛視覺模擬評(píng)分(visual analogue scale,VAS),術(shù)后4、8、12、24 h靜息和術(shù)后4、24 h運(yùn)動(dòng)(屈曲、內(nèi)旋、外旋)疼痛VAS,以及術(shù)后24 h靜脈患者自控鎮(zhèn)痛(patient controlled analgesia,PCA)藥物用量。結(jié)果阻滯組術(shù)中舒芬太尼用量[(17.0±5.7)μg vs.(24.5±8.4)μg,t=-3.308,P=0.002]、術(shù)后24 h PCA用量[(48.1±2.6)ml vs.(52.4±2.8)ml,t=-4.909,P=0.000]均明顯少于對(duì)照組;阻滯組離麻醉恢復(fù)室及術(shù)后4、8、12、24 h靜息疼痛VAS及術(shù)后4 h運(yùn)動(dòng)疼痛VAS明顯低于對(duì)照組(P0.05)。結(jié)論超聲引導(dǎo)下髂筋膜間隙阻滯可為髖關(guān)節(jié)鏡手術(shù)提供良好術(shù)中及術(shù)后鎮(zhèn)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 鹵5.7) 渭 g vs. (24.5 鹵8.4 渭 g / min -3.308 渭 g vs. (0.002] and 24 hours after operation [(48.1 鹵2.6) ml vs. (52.4 鹵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.
【作者單位】： 北京積水潭醫(yī)院麻醉科;
【基金】：北京市科學(xué)技術(shù)委員會(huì)首都臨床特色應(yīng)用研究(課題編號(hào):Z131107002213125)
【分類號(hào)】：R614

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