超声引导下股神经阻滞治疗急诊室股骨骨折患者疼痛的疗效

摘要

目的 评价急诊室股骨骨折患者采用超声引导下股神经阻滞后疼痛缓解的有效性和安全性.方法 股骨骨折患者57例,年龄29～87岁,ASA分级Ⅱ或Ⅲ级,均在急诊室采用超声引导下股神经阻滞,记录股神经阻滞注药前、注药后10、20、30 min时患者VAS评分,注药10 min后VAS评分未明显下降者增加闭孔神经阻滞.结果 34例患者股神经阻滞组注药后10、20、30 min时VAS评分(4.2±1.2、2.6±1.1、2.4±0.9)明显低于注药前(7.3±1.7)(P＜0.05),增加闭孔神经阻滞的23例患者,8例注药后20、30 min时VAS评分(4.1±1.1、3.8±1.2)明显低于注药前(8.0±1.6)(P＜0.05),15例患者注药前后VAS评分没有明显变化.结论 超声引导下股神经阻滞在急诊室对股骨中下段骨折患者疼痛缓解有较好的效果,对股骨上段骨折效果并不太满意.%Objective To evaluate the efficacy and safety of femoral nerve block under ultrasound guidance on the patients with femoral fracture pain in emergency department.Methods Fifty-seven patients with femoral fracture were used femoral nerve block to treat femoral fracture pain under ultrasound guidance in emergency department.VAS was recorded before the block and at 10,20,30 min after the block.Obturator nerve block was added in the patients with no obvious effect with femoral nerve block.Results VAS at 10,20 and 30 min (4.2± 1.2、2.6± 1.1、2.4±0.9) in thirty-four patients was significantly lower after femoral nerve block than pre-block (7.3± 1.7) (P＜0.05).Obturator block was added in twenty-three patients,in eight of them VAS was significantly reduced at 20 and 30 min (4.1 ± 1.1,3.8± 1.2) after the block compared with pre-block(8.0±1.6) (P＜0.05),while VAS in another fifteen patients had no obvious change.Conclusion Ultrasound guided femoral nerve block used in emergency department is of good pain relief in middle and lower femoral bone fractures,with not so good effect in upper femoral fractures.