目的 考察鹽酸丁丙諾啡注射液復(fù)合鹽酸羅哌卡因注射液用于髂筋膜間隙阻滯對老年患者髖部骨折手術(shù)術(shù)后鎮(zhèn)痛效果。方法 選取2020年3月-2022年3月在中化二建集團醫(yī)院行髖部骨折手術(shù)62例患者,將所有患者隨機分為對照組和治療組,每組各31例。超聲引導(dǎo)下行髂筋膜間隙阻滯。對照組注入0.25%鹽酸羅哌卡因注射液40 mL。治療組注入0.15 mg鹽酸丁丙諾啡注射液+0.25%鹽酸羅哌卡因注射液40 mL。記錄兩組術(shù)后12、24、36、48、60、72 h各時間點靜息和活動狀態(tài)下的VAS評分和術(shù)后7 d髖關(guān)節(jié)活動度(ROM)。結(jié)果 與同組24 h靜息狀態(tài)和活動狀態(tài)比較,36、48、60、72 h時對照組和治療組VAS評分均顯著降低,差異有統(tǒng)計學(xué)意義(P<0.05)。治療組術(shù)后靜息狀態(tài)VAS評分在12、24、36、48 h低于對照組,差異有統(tǒng)計學(xué)意義(P<0.05)。治療組在12、24、36、48、60、72 h術(shù)后活動狀態(tài)VAS評分低于對照組,差異有統(tǒng)計學(xué)意義(P<0.05)。與同組1 d比較,術(shù)后7 d每日髖關(guān)節(jié)ROM均顯著升高,差異有統(tǒng)計學(xué)意義(P<0.05);與對照組同期比較,治療組術(shù)后7 d每日髖關(guān)節(jié)ROM均顯著升高,差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 鹽酸丁丙諾啡注射液復(fù)合鹽酸羅哌卡因注射液用于髂筋膜間隙阻滯對老年患者髖部骨折手術(shù)可減輕術(shù)后疼痛,延長鎮(zhèn)痛時間,有利于早期功能鍛煉。

Objective To investigate the analgesic effect of Buprenorphine Hydrochloride Injection combined with Ropivacaine Hydrochloride Injection during fascial iliac compartment block in elderly patients after hip fracture surgery. Methods Patients (62 cases) undergoing hip fracture surgery in The Hospital of Sinochem Second Construction Group from March 2020 to March 2022 were randomly divided into control and treatment groups, and each group had 31 cases. Patient underwent iliac fascia space block under ultrasound guidance. Patients in the control group were im administered with 40 mL 0.25% Ropivacaine Hydrochloride Injection. Patients in the treatment group were im administered with 0.15 mg Buprenorphine Hydrochloride Injection and 40 mL 0.25% Ropivacaine Hydrochloride Injection. The changes of VAS scores for 12, 24, 36, 48, 60, and 72 h after surgery at rest and movement and hip joint range of motion (ROM) for 7 d after surgery were compared between the two groups. Results Compared with the same group's 24 h at rest and movement, the VAS scores of the control group and the treatment group were significantly decreased at 36, 48, 60, and 72 h, with a statistically significant difference (P < 0.05). The VAS scores in the treatment group at rest after surgery were lower than those in the control group at 12, 24, 36, and 48 h, with a statistically significant difference (P < 0.05). The VAS score of postoperative activity in the treatment group was lower than that in the control group at 12, 24, 36, 48, 60, and 72 h, with a statistically significant difference (P < 0.05). Compared with the same group for 1 d, the daily hip ROM increased significantly 7 d after surgery, with a statistically significant difference (P < 0.05). Compared with the control group during the same period, the daily hip ROM in the treatment group increased significantly 7 d after surgery, with a statistically significant difference (P < 0.05).Conclusion Buprenorphine Hydrochloride Injection combined with Ropivacaine Hydrochloride Injection during fascial iliac compartment block in elderly patients after hip fracture surgery can reduce postoperative pain, prolong pain relief time, and facilitate early functional exercise.

R971