Volume 19 Issue 8
Aug.  2021
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ZHU Jian-guo, ZHANG You-chuan, FENG Yi-cheng, ZHU Jun-jian, ZHAN Lin-sen. Effect of ultrasound-guided iliac fascia nerve block on hemodynamics and stress response in elderly patients with proximal femoral fracture[J]. Chinese Journal of General Practice, 2021, 19(8): 1310-1313. doi: 10.16766/j.cnki.issn.1674-4152.002048
Citation: ZHU Jian-guo, ZHANG You-chuan, FENG Yi-cheng, ZHU Jun-jian, ZHAN Lin-sen. Effect of ultrasound-guided iliac fascia nerve block on hemodynamics and stress response in elderly patients with proximal femoral fracture[J]. Chinese Journal of General Practice, 2021, 19(8): 1310-1313. doi: 10.16766/j.cnki.issn.1674-4152.002048

Effect of ultrasound-guided iliac fascia nerve block on hemodynamics and stress response in elderly patients with proximal femoral fracture

doi: 10.16766/j.cnki.issn.1674-4152.002048
Funds:

 2019RC306

  • Received Date: 2021-04-08
    Available Online: 2022-02-16
  •   Objective  To analyze the application of ultrasound-guided iliac fascia nerve block in the anesthesia of elderly patients with proximal femoral fracture and its effect on hemodynamics and stress response.   Methods   Eighty-two cases of elderly patients with proximal femoral fracture in our hospital from March 2019 to December 2020 were selected and randomly divided into group A and group B, 41 cases in each group. Group A was given general anesthesia, and group B was given ultrasound-guided iliac fascia nerve block combined with general anesthesia. The hemodynamic indexes, stress reaction, anesthetic effect and adverse reactions of the two groups were compared.   Results   The arterial pressure of group B after laryngeal mask insertion [(94.70±3.83) mm Hg], 5 min after operation [(96.64±4.05) mm Hg] and at the end of operation [(98.10±3.16) mm Hg] were higher than those of the group A, and the heart rate (88.98±5.54) times/min, (84.17±3.86) times/min, (79.76±4.02) times/min were lower than that of group A (P < 0.05). The postoperative serum cortisol, atrial natriuretic peptide, plasma epinephrine and norepinephrine of group B (11.85±1.72) μg/dL, (0.28 ± 0.02) nmol/L, (37.13±5.95) ng/L, (154.71±45.87) ng/L were lower than those of group A (P < 0.05). The dosage of propofol, recovery time and extubation time of group B (413.03±66.19) mg, (9.86±1.62) min, (12.58±2.79) min were less than those of group A (P < 0.05). The incidence of adverse reactions of group B (7.32%) was lower than that of group A (24.39%), P < 0.05.   Conclusion   Iliac fascia nerve block under ultrasound has little effect on hemodynamics and stress reaction in elderly patients with proximal femoral fracture, and has good anesthetic effect and less adverse reactions, which is worthy of application.

     

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  • [1]
    张宇, 姚富, 于天雷, 等. 超声引导下腹股沟韧带上髂筋膜阻滞对老年股骨近端骨折病人术后疼痛及认知功能的影响[J]. 实用老年医学, 2019, 33(12): 1164-1167. doi: 10.3969/j.issn.1003-9198.2019.12.007
    [2]
    史双友, 靳红绪, 王忠义, 等. 超声引导髂筋膜间隙阻滞在老年股骨近端骨折早期镇痛的临床效果[J]. 重庆医学, 2016, 45(35): 5008-5010. doi: 10.3969/j.issn.1671-8348.2016.35.035
    [3]
    王晓林, 张大志, 李露, 等. 右美托咪定与罗哌卡因髂筋膜间隙阻滞对股骨近端骨折的镇痛效果[J]. 中国医疗设备, 2017, 32(S1): 11. https://www.cnki.com.cn/Article/CJFDTOTAL-YLSX2017S1011.htm
    [4]
    张高行, 陈丽, 马智聪. 髂筋膜阻滞联合右美托咪定在高血压患者股骨近端骨折麻醉前的应用[J]. 遵义医学院学报, 2019, 42(3): 320-323. doi: 10.3969/j.issn.1000-2715.2019.03.015
    [5]
    董祥生. 全麻联合改良髂筋膜间隙阻滞在老年股骨粗隆下部骨干骨折麻醉中的应用[J]. 青岛医药卫生, 2019, 51(5): 361-364. doi: 10.3969/j.issn.1006-5571.2019.05.011
    [6]
    张炳勇, 高涛. 超声引导下行髂筋膜联合腰骶丛神经阻滞和全身麻醉在老年患者髋关节置换术中的对比研究[J]. 中华老年多器官疾病杂志, 2019, 18(9): 688-692. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLQG201909015.htm
    [7]
    吴波. 超声引导髂筋膜间隙阻滞联合全身麻醉在股骨手术中的效果[J]. 医学临床研究, 2018, 35(11): 2130-2132. doi: 10.3969/j.issn.1671-7171.2018.11.017
    [8]
    刘莹莹, 柴彬, 张成炬, 等. 髂筋膜间隙阻滞复合髂腹下——髂腹股沟神经阻滞在老龄髋关节置换术围手术期的镇痛效果[J]. 医学理论与实践, 2018, 31(23): 3547-3548. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLL201823037.htm
    [9]
    王武涛, 赵俊莺, 韩彬, 等. 超声引导连续髂筋膜阻滞在老年性股骨粗隆间骨折固定术后镇痛中的应用[J]. 临床超声医学杂志, 2020, 22(1): 77-78. doi: 10.3969/j.issn.1008-6978.2020.01.030
    [10]
    罗声臻, 潘永英, 盛福庭, 等. 超声引导髂筋膜腔隙与髂腹下/髂腹股沟神经复合阻滞在老年患者髋关节置换术术后镇痛中的作用[J]. 国际麻醉学与复苏杂志, 2017, 38(6): 506-509, 514. doi: 10.3760/cma.j.issn.1673-4378.2017.06.006
    [11]
    彭春潮, 吴婧文, 光文辉, 等. 右美托咪定复合罗哌卡因行外周神经阻滞麻醉在老年股骨近端骨折患者中的应用[J]. 中国老年学杂志, 2020, 40(22): 4771-4774. doi: 10.3969/j.issn.1005-9202.2020.22.023
    [12]
    高燕春, 侯冠峰, 谢言虎, 等. 超声引导下髂筋膜间隙阻滞对老年股骨近端骨折患者术后睡眠质量的影响[J]. 中国医师杂志, 2020, 22(9): 1381-1383. doi: 10.3760/cma.j.cn431274-20190704-00787
    [13]
    KASSAM A M, GOUGH A T, DAVIES J, et al. Can we reduce morphine use in elderly, proximal femoral fracture patients using a fascia iliac block?[J]. Geriatr Nurs, 2018, 39(1): 84-87. doi: 10.1016/j.gerinurse.2017.07.003
    [14]
    邓玉辉, 秦再生, 黄金平. 超声引导髂筋膜间隙置管镇痛与静脉自控镇痛在老年人股骨粗隆骨折术后的对比[J]. 广州医科大学学报, 2017, 45(5): 34-37. doi: 10.3969/j.issn.2095-9664.2017.05.09
    [15]
    彭德良. 观察超声引导下高位髂筋膜间隙阻滞(FICB)对股骨粗隆间骨折患者体位改变时的镇痛效果[J]. 影像研究与医学应用, 2020, 4(8): 249-250. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY202008168.htm
    [16]
    宦乡, 王立伟, 王凯, 等. 超声引导下髂筋膜间隙神经阻滞用于全膝关节置换术的镇痛效果及安全性评价[J]. 广西医科大学学报, 2018, 35(9): 1280-1282. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYD201809028.htm
    [17]
    FAIZ S, NADER N D, NIKNEJADI S, et al. A clinical trial comparing ultrasound-guided ilioinguinal/iliohypogastric nerve block to transversus abdominis plane block for analgesia following open inguinal hernia repair[J]. J Pain Res, 2019, 30(3): 413-420. http://www.dovepress.com/getfile.php?fileID=47358
    [18]
    黄沾, 王中胜, 侯建平, 等. 超声引导下连续髂筋膜间隙阻滞联合单次坐骨神经阻滞用于老年患者全膝关节置换术后镇痛的效果[J]. 检验医学与临床, 2019, 16(18): 2644-2647, 2650. doi: 10.3969/j.issn.1672-9455.2019.18.016
    [19]
    张文超, 白岚, 袁嫕, 等. 超声引导下改良髂筋膜间隙阻滞在老年髋部骨折患者摆放体位过程中的阻滞效果[J]. 临床麻醉学杂志, 2017, 33(10): 957-960. doi: 10.3969/j.issn.1004-5805.2017.10.005
    [20]
    宋亚男, 赵艳, 郭向阳. 围术期应激反应监测指标的研究现状[J]. 中国微创外科杂志, 2017, 17(12): 1129-1132. doi: 10.3969/j.issn.1009-6604.2017.12.021
    [21]
    吉玲玲. B超引导下腰丛-坐骨神经阻滞麻醉复合髂筋膜置管持续镇痛对老年股骨粗隆间骨折患者术中应激反应及术后VAS评分的影响[J]. 中外医学研究, 2020, 18(14): 130-132. https://www.cnki.com.cn/Article/CJFDTOTAL-YJZY202014054.htm
    [22]
    马宁. 超声引导下改良髂筋膜间隙阻滞在老年股骨近端骨折麻醉中的应用[J]. 河南医学研究, 2020, 29(2): 261-262. doi: 10.3969/j.issn.1004-437X.2020.02.032
    [23]
    王建伟, 林康, 徐景友, 等. 超声下髂筋膜神经阻滞联合全麻在老年股骨近端骨折麻醉中的应用[J]. 浙江创伤外科, 2021, 26(1): 191-192. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJCW202101103.htm
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