超声引导下髂筋膜神经阻滞对全髋关节置换术疼痛及睡眠质量的影响

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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

中图分类号：R338.63;R617 文献标识码：A doi：10.3969/j.issn.2095-7130.2025.02.009

全髋关节置换术是临床常用的治疗髋关节疾病的方法，老年人群因身体功能退化，多发骨科疾病，是接受髋关节置换术治疗的主要群体，该术式可明显减轻患者症状，改善生命质量[1]。（剩余5200字）