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髋关节囊周围神经阻滞联合椎管内麻醉在老年股骨粗隆间骨折患者中的应用。

Application of Hip Pericapsular Nerve Block Combined With Spinal Anesthesia in the Treatment of Elderly Patients With Femoral Intertrochanteric Fracture.

机构信息

Department of Anesthesiology, Dongying Hospital Affiliated of Shandong Provincial Hospital Group, Dongying People's Hospital, Shandong, China.

Department of Trauma Orthopedics, Dongying Hospital Affiliated of Shandong Provincial Hospital Group, Dongying People's Hospital, Shandong, China.

出版信息

J Musculoskelet Neuronal Interact. 2024 Jun 1;24(2):178-184.

Abstract

OBJECTIVE

To investigate the effect of pericapsular nerve group (PENG) block combined with spinal anesthesia in the treatment of elderly patients with intertrochanteric fractures through "rapid diagnosis and treatment channel" PFNA internal fixation.

METHODS

52 elderly patients were randomly divided into the observation group (26 patients, PENG block combined with spinal anesthesia) and the control group (26 patients, spinal anesthesia alone). The general health, mean arterial pressure (MAP), and heart rate (HR) of both groups were compared at various stages: immediately before the administration of pain analgesia, during the positioning of spinal epidural anesthesia, at the beginning and end of the surgery, and 2 hours after surgery. Additionally, VAS scores at rest and during passive straight leg elevation by 15° were evaluated at 12 hours, 24 hours, 48 hours, 72 hours, and 7 days after surgery.

RESULTS

The MAP and HR in the observation group under spinal anesthesia in the lateral position were lower than those in the control group (P < 0.05). Additionally, the VAS scores of the observation group during positioning and at 12 hours and 24 hours after surgery were lower than those in the control group under spinal epidural anesthesia (both P < 0.05).

CONCLUSION

The application of ultrasound-guided PENG block combined with lumbar anesthesia can reduce pain when in lateral position, stabilize perioperative vital signs, and result in high satisfaction.

摘要

目的

探讨超声引导下耻骨周围神经群(PENG)阻滞复合椎管内麻醉在老年股骨粗隆间骨折“快速诊治通道”PFNA 内固定术中的应用效果。

方法

将 52 例老年患者随机分为观察组(26 例,PENG 阻滞复合椎管内麻醉)和对照组(26 例,单纯椎管内麻醉)。比较两组在以下各阶段的一般健康状况、平均动脉压(MAP)和心率(HR):疼痛镇痛前给药时、脊髓硬膜外麻醉定位时、手术开始和结束时、术后 2 小时。此外,在术后 12 小时、24 小时、48 小时、72 小时和 7 天,评估患者在静息和被动直腿抬高 15°时的视觉模拟评分(VAS)。

结果

观察组在侧卧位下脊髓麻醉时的 MAP 和 HR 均低于对照组(P<0.05)。此外,观察组在定位时和术后 12 小时、24 小时的 VAS 评分均低于对照组在脊髓硬膜外麻醉下的评分(均 P<0.05)。

结论

超声引导下 PENG 阻滞复合腰麻应用于侧卧位时可减轻疼痛,稳定围术期生命体征,满意度高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a1c/11145325/692759eeb993/JMNI-24-178-g001.jpg

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