论文部分内容阅读
目的探究超声引导下髂筋膜间隙阻滞垂直穿刺对神经阻滞成功率及术后镇痛效果的影响。方法选取2010年1月-2015年4月我院收治的80例骨关节病患者,对其行超声引导下髂筋膜间隙阻滞。根据在腹股沟韧带处超声探头放置方式不同,将80例患者随机分为对照组和观察组,每组40例。对照组超声探头平行放置,观察组超声探头垂直放置。术后两组均行静脉自控镇痛(PCA)。结果观察组超声成像时间及操作时间多于对照组,差异具有统计学意义(P<0.05);观察组股外侧皮神经阻滞成功率为100.0%高于对照组82.5%,差异具有统计学意义(P<0.05);阻滞后4h、8h、12h观察组股外侧皮神经阻滞率高于对照组,差异具有统计学意义(P<0.05);阻滞后8h、12h、24h、36h、48h观察组静脉自控镇痛累计舒芬太尼用量明显少于对照组,差异具有统计学意义(P<0.05)。结论相较于超声探头平行进针,采用垂直穿刺对股外侧皮神经能够起到更好的阻滞效果,术后舒芬太尼使用量明显减少,对骨关节病患者术后镇痛效果更佳。
Objective To investigate the effect of ultrasound-guided vertical puncture of iliac fascia gap on success rate of nerve block and postoperative analgesia. Methods From January 2010 to April 2015, 80 patients with osteoarthropathy admitted to our hospital were enrolled in this study. The patients underwent ultrasound-guided iliac fascia gap arrest. Eighty patients were randomly divided into control group and observation group, 40 cases in each group according to the different placement of ultrasound probe in inguinal ligament. The control group of ultrasound probe placed in parallel, the observation group ultrasound probe placed vertically. Postoperative intravenous controlled analgesia (PCA) was performed in both groups. Results The time of ultrasound imaging and operation time in the observation group were more than those in the control group (P <0.05). The success rate of the lateral femoral cutaneous nerve block in the observation group was 100.0% higher than that in the control group (82.5%), the difference was statistically significant (P <0.05). The rates of lateral cutaneous nerve block in the observation group at 4h, 8h and 12h after the block were significantly higher than those in the control group (P <0.05). After blocking for 8h, 12h, 24h, 36h, 48h observation group intravenous controlled analgesia total sufentanil consumption was significantly less than the control group, the difference was statistically significant (P <0.05). Conclusion Compared with the ultrasound probe parallel to the needle, the use of vertical puncture on the lateral femoral cutaneous nerve can play a better blocking effect, the use of sufentanil decreased significantly postoperative analgesic effect of patients with osteoarthritis good.