中国现代医学杂志2025，Vol.35Issue(5)：18-23,6.DOI:10.3969/j.issn.1005-8982.2025.05.004
超声引导下髂腰肌平面阻滞联合股外侧皮神经阻滞在髋部骨折术中的麻醉效果分析
Analgesic efficacy of ultrasound-guided iliopsoas plane block combined with lateral femoral cutaneous nerve block in hip fracture surgery
摘要
Abstract
Objective To analyze the intraoperative anesthetic efficacy of ultrasound-guided iliopsoas plane block(IPB)combined with lateral femoral cutaneous nerve block(LFCNB)in hip fracture surgery.Methods Eighty-three hip fracture patients admitted to Baoji Hospital of Traditional Chinese Medicine from May 2023 to June 2024 were prospectively enrolled.Using a random number table,patients were divided into two groups:the observation group(n=42)received IPB+LFCNB,and the control group(n=41)received fascia iliaca compartment block(FICB).Outcomes included block-related parameters(procedure time,onset time,first ambulation time),analgesic effects(intraoperative sufentanil boluses,postoperative PC A pump activations,VAS scores),muscle strength[manual muscle testing(MMT)grades],and adverse reactions.Results The observation group demonstrated shorter procedure time,faster onset time,and earlier first ambulation compared to the control group(all P＜0.05).The observation group required fewer intraoperative sufentanil boluses(P＜0.05),fewer postoperative PCA activations(P＜0.05),and exhibited lower VAS scores at rest(P＜0.05)and during 15° hip elevation(P＜0.05)at 8 hours postoperatively.Comparison of MMT grades of observation group and control group at 10 min(T1),2 h(T2),4 h(T3),6 h(T4)and 12 h(T5)after block anesthesia:(1)No significant temporal differences in MMT grades within groups(P＞0.05);(2)Significant intergroup differences in MMT grades(P＜0.05);(3)Significant divergence in MMT grade trends between groups(P＜0.05).No intergroup difference in adverse reaction rates was observed(P＞0.05).Conclusion The IPB+LFCNB protocol reduces procedural time,accelerates anesthesia onset,facilitates early postoperative ambulation,enhances analgesia,and maintains safety in hip fracture surgery.关键词
髋部骨折/髂腰肌平面阻滞/股外侧皮神经阻滞/髂筋膜间隙阻滞/麻醉效果Key words
hip fracture/iliopsoas plane block/lateral femoral cutaneous nerve block/fascia iliaca compartment block/anesthetic efficacy分类
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刘海超,尹昭慧..超声引导下髂腰肌平面阻滞联合股外侧皮神经阻滞在髋部骨折术中的麻醉效果分析[J].中国现代医学杂志,2025,35(5):18-23,6.基金项目
陕西省重点研发计划项目社会发展领域(No:2022SF-237) （No:2022SF-237）
