神经阻滞用于急性单纯骨折病人的术前镇痛

NEURAL BLOCK IN THE PREOPERATIVE ANALGESIA OF ACUTE SIMPLE FRACTUER

摘要:

目的比较观察骨折病人做神经阻滞镇痛和哌替啶肌注镇痛的效果.方法将107例骨折病人分两组,A组采用骨折后肌注哌替啶1mg/kg(n=55);B组在骨折后采用相应部位的神经阻滞镇痛(n=52),分别记录治疗后10,30,60min时的VAS值和并发症.结果B组治疗后30min无痛率为19%,而B组为4%,显效率B组54%.A组27%,两组间比较无痛率和显效率均为B组高于A组,P＜0.01,有非常显著的差异.治疗后1h无痛率A组和B组分别为5%和23%,显效率分别为39%和58%,两组间比较无痛率和显效率B组高于A组,P＜0.05,有显著差异.B组恶心呕吐发生率明显低于A组.结论对骨折创痛病人应用神经阻滞法解除骨折创痛,其效果优越于肌注哌替啶,且并发症少.

Abstract:

Purpose: To compare the analgesic effect induced by preoperative nerve block and dolantine injection in fracture patients. Method: The 107 patients were divided into two groups. The group A was given dolantine injection after fracture (n=55). Group B was given nerve block of coresponding part after fracture (n=52). Visual analogue score (VAS) for pain and complications were recorded 10 min, 30 min and 60 min after the treatment. Result: 30min after treatment, painless rate was 19% in group B, and 4% in group A, marked improvement was 54% in group B, and 27% in group A ( P <0.01). One hour after treatment, painless rate was 23% in group B, and 5% in group A. Effective rate was 58% in group B, and 39% in group A ( P <0.05). The occurance of nausia and vomitting was significantly lower in group B. Conclusion: The preoperative nerve block analgesia is a preferable method to relief the pain for fracture patients, with higher efficacy and lower complication than that of dolantine injection.