摘要
目的:探究针刺与腰丛神经阻滞用于全髋关节置换术(THA)超前镇痛中的效果。方法:采用随机数字表法将60例接受THA治疗患者均分为两组。两组术中均接受气管插管全麻,西医组麻醉诱导开始前30 min给予腰丛神经阻滞进行超前镇痛,中医组则采用针刺双下肢麻点和腕踝关节相应部位。比较两组术后镇痛、镇静效果。结果:两组手术时间比较差异无统计学意义(P>0.05),术后1、6、24、48 h静息和活动状态下的VAS评分,术后6、24、48 h的Ramsay镇静评分、累计镇痛泵按压次数、血清PGE_(2)水平和48 h内镇痛补救次数比较差异均无统计学意义(P>0.05),但中医组麻醉苏醒时间和拔管时间明显短于西医组,术后6、24、48 h的血清β-EP水平明显高于西医组,差异均具有统计学意义(P<0.05)。结论:针刺内麻点和腕踝穴位超前镇痛与腰丛神经阻滞超前镇痛均可为THA患者提供有效的术后镇痛和镇静,且前者能缩短患者术后苏醒时间和拔管时间。
Objective:To explore the effect of acupuncture anesthesia and lumbar plexus block on preemptive analgesia in total hip arthroplasty(THA).Methods:60 patients who received THA treatment were randomly divided into two groups.Both groups received general anesthesia with tracheal intubation during operation,and all patients were given patient-controlled intravenous analgesia after operation.The western medicine group was given lumbar plexus block for preemptive analgesia 30 minutes before anesthesia induction,while the Chinese medicine group was given electroacupuncture to stimulate the numbness of both lower limbs and the corresponding parts of wrist and ankle joint.The postoperative analgesic and sedative effects of the two groups were compared.Results:There was no significant difference in the operation time between the two groups(P>0.05),and there were no significant differences in VAS scores at rest and activity at 1、6、24、48 h after operation,Ramsay sedation scores at 6、24、48 h after operation,the cumulative number of analgesic pump presses,serum PGE_(2) level and the number of analgesic remedies within 48 h(P>0.05),but the anesthesia recovery time and extubation time in Chinese medicine group were obviously shorter than those in western medicine group,and the serumβ-EP levels at 6、24、48 h after operation were significantly higher than those in western medicine group(P<0.05).Conclusion:Acupuncture at internal hemp points and wrist-ankle points for preemptive analgesia and lumbar plexus block for preemptive analgesia can provide effective postoperative analgesia and sedation for THA patients,and the former can shorten postoperative awakening time and extubation time.
作者
邓亚南
潘小妮
刘鑫
荀梅
DENG Yanan;PAN Xiaoni;LIU Xin;XUN Mei(Xi’an Jiaotong University,Honghui Hospital,Xi’an 710054,China)
出处
《陕西中医》
CAS
2022年第10期1455-1458,共4页
Shaanxi Journal of Traditional Chinese Medicine
基金
陕西省自然科学基础研究计划项目(S2021-JC-YB-2604)。
关键词
全髋关节置换术
镇痛
超前
针刺
腰丛神经阻滞
Total hip arthroplasty
Analgesia
Advance
Electroacupuncture stimulation
Lumbar plexus block
