| Object: To investigate the effect of continuous iliac fascia block(FICB)and intravenous analgesia on postoperative analgesia in different areas of lower extremities under ultrasound guidance and to explore the effects of two different modes of ultrasound on FICB after hip replacementeffect evaluation.The aim is to provide effective evidence that control postoperative pain is beneficial to early rehabilitation of patients.Methods: 1)The sixth affiliated hospital of xingjiang medical university has performed surgery amount to 240 cases between March 2015 and August 2017,which include the hip replacement(80cases),fracture reduction of femoral shaft fracture(80cases),knee replacement(80cases).anesthesia classification in the ASA I-III level under the implementation of hard waist combined block anesthesia complete the operation.Under randomized doubleblind control,the samples were divided into THA group,TKA group and femoral stem group,and each group’s eightycases were randomly treated with numbers.Then,80 cases of each group were divided into control group and experimental group.After the operation,the patients of the experimental group was treated with continuously iliac fascia block(FICB)with ultrasound guidance,while the control group was treated with peripheral venous analgesia.The postoperative symptoms of patiets were obsevered closely,if the patient hada strong pain symptom,50-100 mg tramadol rescue would be given.After making postoperative quiescent pain score,subjective pain score and passive pain score,the number ofpostoperative tramadol used within 48 hours would be recorded.Besides,the patient’s satisfaction degree and the incidence of adverse events were recorded and evaluated.2)In the Sixth Affiliated Hospital of Xinjiang Medical University during the period from March 2015 to August 2017,collected hip arthroplasty(60cases)and signed informed consent.anesthesia.sixtypatient(ASA I-III),who had finished combined spinal-epidural anaesthesia(CSEA)undergoing THA were randomly dividedinto two groups: the group that iliac fascia nerve wasblockedinferior inguinal ligament with ultrasound guidance and another group that iliac fascia nerve was blocked superior inguinal ligament with ultrasound guidance.The analgesia of the continuous nerve block of the iliac fascia was used in the ultrasonic descending iliac fascia,settingthat the concentration of two analgesic pumps were both 0.2% ropivacaine 200 ml,the load was 20 ml,the background volume was 0 and PCA was 5ml / times,time limitedin one hour.Patients’ postoperative quiescent pain score,continuous passive pain score and subjective pain score were evluated and recorded.Then,the patients’ incidence of adverse reactions,the number of used tramadol and the satisfaction degree would be affirmed.Results: 1)The experimental result’s difference between the two groups about weight,age,operation time,gender,ASA degree and other aspects was short of statistically significant.Compared to the control group,the usage amount of the tramadol analgesic in the experimental groupwas less,and the resting pain,active exercise pain and passive motor pain were smaller.The results showed that the adverse reactions were less in the experimental group and the patient’s satisfaction degree was higher.Differences above were statistically significant(P<0.05).2)The experimental result’s difference between the two groups about age,height,weight,operation time,gender and ASA degree and other aspects was short of statistically significant.Compared to the control group,the usage amount of the tramadol analgesic in the experimental groupwas less,and the resting pain,active exercise pain and passive motor pain were smaller.The results showed that the adverse reactions were less in the experimental group and the patient’s satisfaction degree was higher.Differences above were statistically significant(P<0.05).Conclusion: 1)After hip arthroplasty,knee arthroplasty and femoral shaft fracture,compared with the peripheral vein continuous analgesic group,ultrasound guided iliac fascia continuous nerve block group made the patient’s rate of adverse reactionslower and satisfaction degree higher.With the injection of 0.2% ropivacain with ultrasound guided when finished hip arthroplasty.,the continuous iliac fascia block superior inguinal ligament was more effective than that the continuous iliac fascia block inferior inguinal ligament.Studies have showed that control postoperative pain can help patients with postoperative rehabilitation training and prognosis recovery.it is a new shortcut to alleviate patients with their postoperative pain... |
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