中国现代医学杂志2025，Vol.35Issue(5)：7-11,5.DOI:10.3969/j.issn.1005-8982.2025.05.002
布比卡因脂质体髋关节囊神经阻滞在老年股骨粗隆间骨折中的应用效果研究
Application of liposomal bupivacaine for pericapsular nerve group block in elderly patients with intertrochanteric fractures
摘要
Abstract
Objective To analyze the efficacy of liposomal bupivacaine for pericapsular nerve group(PENG)block in elderly patients with intertrochanteric fractures.Methods A retrospective analysis was conducted on clinical data of 81 elderly patients with intertrochanteric fractures admitted to Baoji Hospital of Traditional Chinese Medicine from June 2022 to May 2023.All patients received combined spinal anesthesia and PENG block.They were divided into a control group(n=40,treated with levobupivacaine hydrochloride)and an observation group(n=41,treated with liposomal bupivacaine).Results Outcomes included pain intensity at rest and during movement(VAS scores),cognitive status(MMSE scores),serum pain mediator levels[substance P(SP),β-endorphin(β-EP),nitric oxide(NO),and 5-hydroxytryptamine(5-HT)],and anesthesia-related adverse reactions at different time points.Results For VAS scores(rest/movement):(1)Significant differences were observed across time points(preoperative,30 min post-block,and 6 h postoperatively)in both groups(P＜0.05).(2)The observation group showed significantly lower VAS scores than the control group(P＜0.05),indicating superior analgesia.(3)Intergroup trends in VAS scores differed significantly(P＜0.05).For MMSE scores(preoperative,24 h,and 48 h postoperatively):(1)Significant differences were observed across time points(P＜0.05).(2)The observation group had significantly higher MMSE scores than the control group(P＜0.05),reflecting better cognitive preservation.(3)Intergroup trends in MMSE scores differed significantly(P＜0.05).The observation group exhibited greater reductions in SP,NO,and 5-HT levels post-treatment compared to the control group(P＜0.05),with a smaller reduction in β-EP(P＜0.05).No significant difference in overall adverse reaction rates was observed between groups(P＞0.05).Conclusion Liposomal bupivacaine for PENG block in elderly intertrochanteric fracture patients provides effective analgesia,modulates pain-related mediators,and demonstrates favorable safety.关键词
股骨粗隆间骨折/老年/布比卡因脂质体/髋关节囊周围神经阻滞Key words
intertrochanteric fracture/elderly/liposomal bupivacaine/pericapsular nerve group block分类
临床医学引用本文复制引用
刘畅,鲁涛..布比卡因脂质体髋关节囊神经阻滞在老年股骨粗隆间骨折中的应用效果研究[J].中国现代医学杂志,2025,35(5):7-11,5.基金项目
陕西省科学技术厅一般项目(No:2022SF-422) （No:2022SF-422）
