超聲引導(dǎo)下髂筋膜神經(jīng)阻滯對全髖關(guān)節(jié)置換術(shù)疼痛及睡眠質(zhì)量的影響

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Effects of Ultrasound-Guided Iliac Fascial Nerve Block on Hemodynamics， Pain and Sleep Quality During Total Hip Replacement Surgery

LIU Zhiyun， YIN Hong

（Departmentof Anesthesiology，Taizhou Hospital of Traditional Chinese Medicine，Taizhou 2253oo，China）

AbstractObjective：Toanalyzetheefects ofultrasound-guidediliacfascialnerve blockonhemodynamics，painandsleepqualityduringtotalhipreplacementsurgeryMethods：Atotalof 8Opatientsunderwenttotalhipreplacementsurgeryatthehospital from Janary2O23toJanuary2O24 wereselected.Acording totheanesthesia methods，theywere dividedintothelumbaranesthesia group（ n=40 ，spinal anesthesia） and the nerve block group（ n=40 ，ultrasound-guided iliac fascial nerve block combined with spinalanesthesia）.The hemodynamicindicators，postoperativepaindegree，andsleepqualitywerecomparedbetweenthetwo groups. Results：There were statistically significant differences （ P<0.05 ） in the mean arterial pressure（MAP） and heart rate （HR）of thelumbaranesthesiagroupafteranesthesiapositioning，uringsurgery，nd6hoursaftersurgery.There werenoatistically significant differences in MAP and HR between the nerve block group at different time periods （ P>0.05 ）. The MAP and HRofthenerve blockgroup were significantlyhigherthanthoseofthelumbaranesthesia groupafteranesthesia positioningand during surgery，and were significantly lower than those of the lumbar anesthesia group （ P<0.05）. The Visual Analogue Scale （VAS）scores forpain inthe nerveblock group weresignificantlylower thanthoseinthelumbar anesthesia groupattheendof surgery，12 hours，24 hours and 48 hours after surgery（ P<0.05 ）. The Pitsburgh Sleep Quality Index（PSQI） scores in the nerve block group were significantly lower than those in the lumbar anesthesia group on postoperative day1 and day 3（ P<0.05， ）. Conclusion：Ultrasound-guidediliacfascialnerve block canhelpstabilizehemodynamics，aleviatepain，and improve sleepquality during total hip replacement surgery.

KeywordsUltrasound-guided；Iiac fascial nerve block；Spinalanesthesia；Total hipreplacementsurgery；Hemodynamics; Pain；Sleep quality；Mean arterial pressure

中圖分類號：R338.63;R617 文獻(xiàn)標(biāo)識碼：A doi：10.3969/j.issn.2095-7130.2025.02.009

全髖關(guān)節(jié)置換術(shù)是臨床常用的治療髖關(guān)節(jié)疾病的方法，老年人群因身體功能退化，多發(fā)骨科疾病，是接受髖關(guān)節(jié)置換術(shù)治療的主要群體，該術(shù)式可明顯減輕患者癥狀，改善生命質(zhì)量[1]。（剩余5200字）