超声引导下髂筋膜间隙阻滞在老年髋部骨折患者早期镇痛中的应用

目的 评价超声引导下髂筋膜间隙阻滞(FICB)在老年髋部骨折患者早期镇痛中的应用.方法 选取2018年1月—2018年12月中国医科大学附属盛京医院收治的80例老年髋部骨折患者作为研究对象,采用随机数字表法将其分为超声引导下行FICB(实验组)和静脉注射氟比洛芬酯镇痛(对照组),每组40例.实验组在超声引导下行FICB...

The effects of ultrasound-guided fascia iliaca compartment block onearly analgesia in elderly patients with hip fracture

Objective To observe the effects of ultrasound-guided fascia iliaca compartment block on earlyanalgesia in elderly patients with hip fracture. Methods Eighty elderly patients with hip fracture admitted to ourhospital from January 2018 to December 2018 were selected and categorized randomly into group F and group N,with 40 cases in each group. In group F, patients were treated with ultrasound-guided fascia iliaca compartmentblock, and 0.3% ropivacaine was injected. In group N, 50 mg flurbiprofen was injected. The visual analogue scale(VAS) scores, mean arterial pressure (MAP) and heart rate (HR) right before (T0) and 30 min (T1), 1 h (T2), 6 h (T3)and 12 h (T4) after analgesia were evaluated. The incidences of adverse reactions including nausea and vomiting, drowsiness, urinary retention, hypotension, bleeding and hematoma at the puncture sites, and local anestheticsintoxication were compared between the two groups. The number of patients taking oxycodone and acetaminophentablets and the dosages of the tablets were recorded and compared between the two groups. Results The VAS atrest (RVAS) and VAS after passive movement (PVAS) scores were different between the two groups and altered atdifferent time points (T1, T2, T3 and T4) (P < 0.05), while there was no significant difference in the changing trends ofthe scores (P > 0.05). There was no difference in MAP at rest between the two groups or at different time points, andno significant difference was found in the changing trends of MAP at rest (P > 0.05). The MAP and HR after passivemovement were different between the groups and altered at different time points with distinct changing trends (P <0.05). The HR at rest was different between the groups (P < 0.05) but was not different at different time points (P >0.05), and there was no difference in the changing trends of HR at rest (P > 0.05). Two patients in group F (5%) andnine patients in group N (22.5%) took oxycodone and acetaminophen tablets, and the average dosages were 1 tabletand 2 tablets, respectively (P < 0.05). As for the adverse reactions, one patient in group F (2.5%) and six patients ingroup N (15%) developed nausea and vomiting (P < 0.05). Conclusion Ultrasound-guided fascia iliacacompartment block can be safely used in elderly patients and provide effective early analgesia for hip fracture.