右美托咪定作为局麻药佐剂用于超声下髂筋膜间隙阻滞在老年股骨骨折应用研究OA
Dexmedetomidine as a local anesthetic adjuvant in ultrasound-guided fascia iliaca compartment block for elderly patients with femoral fractures
目的:探讨右美托咪定(DEX)作为局麻药佐剂用于老年股骨骨折超声下髂筋膜间隙阻滞(FICB)的效果.方法:选择2024年3月至2025年6月抚州市东乡区人民医院收治的老年股骨骨折患者60例,按照随机数字表法分为观察组和对照组,每组各30例;对照组予罗哌卡因超声引导下FICB,观察组予DEX加罗哌卡因超声引导下FICB;对比2组患者的血流动力学指标[入室后(T0)、神经阻滞10 min后(T1)、侧卧位摆放体位时(T2)、术毕时(T3)平均动脉压、心率]、术后疼痛程度[采用视觉模拟法(VAS)]、麻醉效果、血管活性药物使用次数及康复时间等.结果:2组手术时间比较差异无统计学意义(P＞0.05);观察组T0～T3时间点平均动脉压、心率比较差异无统计学意义(P＞0.05);对照组T1～T3时间点平均动脉压、心率均较T0降低,且低于观察组(P＜0.05);观察组术后6、12、24、48 h VAS评分均低于对照组(P＜0.05);观察组阻滞起效时间低于对照组,消退时间长于对照组,血管活性药物使用次数少于对照组(P＜0.05);2组术后首次下床时间、总住院时间比较,差异无统计学意义(P＞0.05).结论:老年股骨骨折采用DEX作为局麻药佐剂用于超声下FICB可稳定血流动力学,减轻术后疼痛程度,提高麻醉效果,减少血管活性药物使用,且对康复指标无影响.
Objective:To investigate the effect of dexmedetomidine(DEX)as a local anesthetic adjuvant in ultrasound-guided fascia iliaca compartment block(FICB)in elderly patients with femoral fractures.Methods:Sixty elderly patients with femoral fractures admitted to Dongxiang District People's Hospital of Fuzhou City from Mar 2024 to Jun 2025 were selected and randomly divided into an observation group and a control group,with 30 cases in each group.The control group received ropivacaine under ultrasound-guided FICB,while the observation group received DEX combined with ropivacaine under ultrasound-guided FICB.Hemodynamic indicators[mean arterial pressure and heart rate at T0(after entering the operating room),T1(10 min after nerve block),T2(when the lateral position was placed),and T3(at the end of the operation)],postoperative pain degree[assessed by visual analogue scale(VAS)],anesthetic efficacy,frequency of vasoactive drug use,and recovery time were compared between the two groups.Results:There was no statistically significant difference in surgical time between the two groups(P＞0.05).Mean arterial pressure and heart rate at T0-T3 showed no statistically significant difference in the observation groups(P＞0.05).In the control group,mean arterial pressure and heart rate at T1-T3 were lower than those at T0 and were also lower than those in the observation group(P＜0.05).VAS scores at 6,12,24,and 48 h postoperatively in the observation group were lower than those in the control group(P＜0.05).The onset time of blockade was shorter while the duration of blockade was longer in the observation group than those in the control group(P＜0.05).The number of vasoactive drug administrations was lower in the observation group than that in the control group(P＜0.05).There was no statistically significant difference between the two groups in the time to first ambulation or total hospitalization duration(P＞0.05).Conclusion:The use of DEX as a local anesthetic adjuvant in ultrasound-guided FICB for elderly patients with femoral fractures can stabilize hemodynamics,reduce postoperative pain,improve anesthetic efficacy,reduce the use of vasoactive drugs,and has no effect on recovery indicators.
胡琛;于江秀;董晨晨
抚州市东乡区人民医院麻醉科,江西 抚州 331800抚州市东乡区人民医院麻醉科,江西 抚州 331800抚州市东乡区人民医院麻醉科,江西 抚州 331800
医药卫生
股骨骨折老年右美托咪定超声下髂筋膜间隙阻滞
femoral fractureselderly patientsdexmedetomidineultrasound-guided fascia iliaca compartment block
《沈阳医学院学报》 2026 (3)
264-268,5
抚州市社会发展指导性科技计划项目(No.抚科社学[2024]6号-121)
评论