目的 考察盐酸丁丙诺啡注射液复合盐酸罗哌卡因注射液用于髂筋膜间隙阻滞对老年患者髋部骨折手术术后镇痛效果。方法 选取2020年3月-2022年3月在中化二建集团医院行髋部骨折手术62例患者,将所有患者随机分为对照组和治疗组,每组各31例。超声引导下行髂筋膜间隙阻滞。对照组注入0.25%盐酸罗哌卡因注射液40 mL。治疗组注入0.15 mg盐酸丁丙诺啡注射液+0.25%盐酸罗哌卡因注射液40 mL。记录两组术后12、24、36、48、60、72 h各时间点静息和活动状态下的VAS评分和术后7 d髋关节活动度(ROM)。结果 与同组24 h静息状态和活动状态比较,36、48、60、72 h时对照组和治疗组VAS评分均显著降低,差异有统计学意义(P<0.05)。治疗组术后静息状态VAS评分在12、24、36、48 h低于对照组,差异有统计学意义(P<0.05)。治疗组在12、24、36、48、60、72 h术后活动状态VAS评分低于对照组,差异有统计学意义(P<0.05)。与同组1 d比较,术后7 d每日髋关节ROM均显著升高,差异有统计学意义(P<0.05);与对照组同期比较,治疗组术后7 d每日髋关节ROM均显著升高,差异有统计学意义(P<0.05)。结论 盐酸丁丙诺啡注射液复合盐酸罗哌卡因注射液用于髂筋膜间隙阻滞对老年患者髋部骨折手术可减轻术后疼痛,延长镇痛时间,有利于早期功能锻炼。

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