Application of continuous iliac fascial interstitial obstruction in the placement of anaesthesia in the vertebral canal of the elderly femoral fractures and postoperative analgesia
10.3760/cma.j.issn.1008-6706.2018.09.009
- VernacularTitle: 连续髂筋膜间隙阻滞术用于老年人股骨骨折椎管内麻醉前摆放体位及术后镇痛的效果观察
- Author:
Lizhao JIN
1
;
Tijie DING
;
Meihua HUANG
;
Xianghuan CHEN
Author Information
1. Department of Anesthesiology, the People's Hospital of Cangnan County, Zhejiang 325800, China
- Publication Type:Journal Article
- Keywords:
Iliac fascia space block;
Femoral fracture;
Elderly;
Postoperative analgesia
- From:
Chinese Journal of Primary Medicine and Pharmacy
2018;25(9):1121-1125
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of continuous iliac fascia space block on the placement of body position and postoperative analgesia in patients with femoral fractures.
Methods:60 patients with senile selective unilateral femoral fracture, aged 68-87 years old, weight 49-70kg, ASA grade II-III were selected, and they were randomly divided into iliac fascia block group (A group) and intravenous analgesia group (B group) according to the digital, 30 cases in each group.The two groups underwent lumbar epidural anesthesia, A group received continuous fascia iliaca compartment block 15 min before the the body position.B group was routinely given combination of lumbar and hard anesthesia.After operation, A group was connected with the automatic infusion pump continuous infusion of 0.2% ropivacaine 0.1mL·kg-1·h-1.B group received controlled intravenous analgesia, postoperative given loading dose of dezocine intravenous infusion of 5mg with automatic injection pump for dezocine 0.01mg·kg-1·h-1.When the patients entered the room (T0) and just after the placement of the body position (T1), the heart rate, diastolic blood pressure and systolic blood pressure were measured and recorded.At postoperative 2, 4, 6, 12, 24 and 48h, the VAS scores and pethidine usage during surgery, the adverse reaction were recorded.
Results:The heart rate, diastolic pressure and systolic pressure at T1 in A group had no significant change compared with T0 (all P>0.05). The heart rate, diastolic pressure and systolic pressure in the control group (B group) at T1 were significantly higher than at T0(t=5.302, 7.369, 5.629, all P<0.05). At T1, T2, T4, T6, T12, T24 and T48, the pain VAS scores in A group were lower than those in B group (t1=66.401, t2=7.719, t4=25.260, t6=13.170, t12=3.837, t24=3.081, t48=6.202.all P<0.05). The study group had no complications such as puncture hematoma, intoxication of local anesthetic and other complications.
Conclusion:Continuous iliofascial block can provide continuous analgesia for elderly patients with femoral fractures.It is safe and effective, and is easy to perform.It provides favorable conditions for later operative treatment.
