So sánh hiệu quả giảm đau cho bệnh nhân gãy xương dài chi dưới của gây tê thần kinh đùi và gây tê thần kinh hông to với chuẩn độ morphin tĩnh mạch=Comparison between ultrasound-guided sciatic-femoral nerve block and intravenous morphin to reduce pain for patients with lower extremity fractures: Results of an observational study

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Hữu Tú Nguyễn, Đình Lượng Vũ, Minh Hải Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2024

Mô tả vật lý: tr.162-169

Bộ sưu tập: Metadata

ID: 244673

Thêm vào giỏ

Femoral nerve block (FNB) combined with an anterior sciatic nerve block (SNB) along the anterior pathway of the patient in supine position can reduce pain and discomfort, but could worsen the bone fractures in patients. However, FNB and SNB could be performed with ultrasound guidance hence decrease the chance to worsen the patient’s condition. The study aimed to compare the effectiveness of FNB and SNB with ultrasound guidance and intravenous morphine for pain relief in 130 patients with lower extremity fractures. Sixty five patients in Group L received FNB and SNB, in the supine position, while 65 patients in Group M received intravenous morphine. There were no difference in age, gender, diagnosis, and causes of bone fractures between the two groups. The duration of FNB and SNB was 4,78 ± 1,65 minutes, and the duration of morphine administration was 20,08 ± 3,5 minutes. The effective pain relief time was 122.5 ± 5.3 minutes in Group L and 85.5 ± 5.3 minutes in Group M. The average VAS score after 25 minutes of injection was 0.34 ± 0.08 in Group L and 3.34 ± 0.08 in Group M. No patient in both groups experienced vascular disorders, blood pressure changes, motor inhibition, nausea or vomiting, or itching. The combination of FNB and SNB along the anterior pathway with ultrasound guidance is a safe, fast, and effective pain relief technique compared to intravenous morphine.Gây tê thần kinh đùi (FNB) phối hợp gây tê thần kinh hông to (SNB) theo đường trước bệnh nhân nằm ngửa tránh thay đổi tư thế gây đau đớn, khó chịu, thậm chí có thể làm nặng thêm tổn thương gẫy xương ở người bệnh. Nghiên cứu được thực hiện nhằm so sánh hiệu quả của FNB và SNB đường trước dưới hướng dẫn của siêu âm với giảm đau bằng morphin tĩnh mạch cho 130 bệnh nhân gãy xương dài chi dưới. 65 bệnh nhân nhóm L thực hiện FNB và SNB, tư thế nằm ngửa
65 bệnh nhân nhóm M sử dụng morphin tĩnh mạch. Không có sự khác biệt về tuổi, giới, chẩn đoán và nguyên nhân gãy xương. Thời gian thực hiện FNB và SNB là 4,78 ± 1,65 phút. Thời gian chuẩn độ morphin là 20,08 ± 3,5 phút. Thời gian khởi phát hiệu quả giảm đau nhóm L 13,58 ± 2,6 phút
nhóm M là 25,08 ± 3,59 phút. Điểm VAS trung bình sau tiêm 15 phút là 0,34 ± 0,08 nhóm L và 3,02 ± 0,54 nhóm M. Cả 2 nhóm không có bệnh nhân rối loạn mạch, huyết áp
không ức chế vận động, không có bệnh nhân nôn và buồn nôn, không có bệnh nhân bị ngứa. Phối hợp FNB và SNB đường trước dưới hướng dẫn của siêu âm là kỹ thuật giảm đau an toàn, nhanh và hiệu quả hơn so với sử dụng morphin tĩnh mạch.

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