超声引导下髂筋膜阻滞联合酮咯酸对全髋置换老年患者术后康复效果的研究进展

Research Progress on the Effect of Ultrasound-Guided Fascia Iliaca Block Combined with Ketorolac Tromethamine on Postoperative Rehabilitation in Elderly Patients Undergoing Total Hip Replacement

摘要: 全髋置换术是老年患者终末期髋关节病变的有效治疗方法。但手术后通常有较严重的疼痛，有效的术后疼痛管理是手术成功的关键，不仅能改善预后，还可以减少并发症和慢性疼痛风险。超声下髂筋膜间隙阻滞(FICB)已广泛应用于髋关节置换术后止痛，但单纯髂筋膜阻滞后仅有部分镇痛效果，单用于髋关节置换术镇痛效果并不充分，仍需要联合其他的辅助止痛手段。酮咯酸氨丁三醇是非甾体类抗炎药的一种，它主要通过抑制环加氧酶(COX)有效抑制前列腺素生物合成，起到消炎止痛的效果。结合超声引导下FICB的优势，考虑可与酮咯酸联合，以提高老年髋置换术患者的术后康复效果和满意度，但目前二者联合应用的相关研究较少，本文就超声引导下髂筋膜阻滞联合酮咯酸对全髋置换老年患者术后康复效果进行综述。

Abstract: Total hip replacement is an effective treatment for end-stage hip disease in older patients. However, there is often more severe pain after surgery, and effective postoperative pain management is the key to the success of surgery, not only improving prognosis but also reducing the risk of complica-tions and chronic pain. Fascia iliaca space block (FICB) has been widely used for analgesia after hip arthroplasty, but fascia iliaca block alone has only partial analgesic effect, and the analgesic effect of hip arthroplasty alone is not sufficient, and other auxiliary analgesic methods are still needed. Ke-torlac tromethamine is a non-steroidal anti-inflammatory drug, which effectively inhibits prosta-glandin biosynthesis mainly by inhibiting cyclooxygenase (COX), which has the effect of an-ti-inflammatory and analgesic. Combined with the advantages of ultrasound-guided FICB, it is con-sidered that it can be combined with ketorolac tromethamine to improve the postoperative reha-bilitation effect and satisfaction of elderly patients undergoing hip replacement, but there are no relevant studies on the combined application of the two.