Application of iliac fascia plane block combined with wrist-ankle acupuncture in perioperative analgesia of hip arthroplasty
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摘要: 目的 观察髂筋膜平面阻滞复合腕踝针在髋关节置换术后的镇痛效果。 方法 将60例硬膜外麻醉下行髋关节置换术的患者随机分为2组,均在硬膜外麻醉前行超声引导下患侧髂筋膜阻滞,试验组患者术后行腕踝针阻滞,并对2组中术后疼痛评分超过4分者给予曲马多注射液。记录2组患者术后1、6、12、24、36、48 h的视觉模拟评分法(VAS)评分,比较2组术后镇痛药使用量和不良反应发生率。 结果 试验组术后6、12、24 h的VAS评分显著低于对照组(P<0.05), 2组患者术后1、36、48 h的VAS评分比较,差异无统计学意义(P>0.05); 试验组曲马多注射液用量显著少于对照组(P<0.05); 试验组患者的总不良反应发生率显著低于对照组(P<0.01)。 结论 髂筋膜阻滞联合腕踝针针刺能明显减轻患者的的术后疼痛,减少术后镇痛药的使用量以及术后并发症的发生。Abstract: Objective To observe the analgesic effect of iliac fascia plane block combined with wrist-ankle acupuncture after hip arthroplasty. Methods Sixty patients undergoing epidural subdural hip arthroplasty were randomly divided into two groups. Patients in both groups received ultrasound-guided iliac fascia block on the affected side before epidural anesthesia, while those in the experimental group received wrist-ankle acupuncture block. The patients with Visual Analogue Scale scoring more than 4 points were injected with tramadol hydrochloride injection. The Visual Analogue Scale(VAS)scores at 1, 6, 12, 24, 36 and 48 hours after operation was recorded, and postoperative analgesic dosage and adverse reactions of the two groups were recorded. Results The VAS scores at 6, 12 and 24 h after operation in the experimental group were lower than those in the control group(P<0.05).There were no significant differences in VAS scores between the two groups at 1, 36 and 48 h after operation(P>0.05).The dosage of tramadol hydrochloride injection in the experimental group was significantly less than that in the control group(P<0.05).The incidence of adverse reactions in the experimental group was significantly lower than that in the control group(P<0.05). Conclusion Iliofascial block combined with wrist-ankle acupuncture can significantly relieve postoperative pain, reduce the amount of postoperative analgesics and the incidence of postoperative complications.
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