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腰方肌阻滞、髂筋膜阻滞与非神经阻滞对全髋关节置换术后镇痛效果的网状Meta分析
杨程杰, 周军, 魏继承
西南医科大学附属医院麻醉科,四川 泸州 610041
摘要:
目的 比较腰方肌阻滞、髂筋膜阻滞及非神经阻滞对全髋关节置换术后疼痛的镇痛效果。方法 检索Pubmed、EMbase、Cochrane-Library、CNKI数据库从建库至2020年7月,纳入三种镇痛方式用于全髋置换术的随机对照试验,用ADDIS1-16-8软件行网状Meta分析。结果 纳入11项研究共606例患者。三种镇痛方式相比,患者术后6~48 h疼痛评分、24 h吗啡用量及恶心、呕吐发生率由低到高排序为:腰方肌阻滞、髂筋膜阻滞、非神经阻滞。结论 对于全髋关节置换术,相较于非神经阻滞与髂筋膜阻滞,腰方肌阻滞提供更完善的术后镇痛,且能减少阿片类药物用量及不良反应发生率。因此,腰方肌阻滞可能作为全髋关节置换术后镇痛的一种替代方式。
关键词:  腰方肌阻滞  髂筋膜阻滞  全髋关节置换术  术后镇痛  网状Meta分析
DOI:10.16252/j.cnki.issn1004-0501-2021.01.009
分类号:R614
文章编号:1004-0501(2021)01-0035-05
文献标识码:A
基金项目:
Quadratus Lumborum Block,Fascia Iliaca Compartment Block and No Block for Postoperative Analgesia of Total Hip Arthroplasty:A Network Meta-analysis.
Yang Chengjie, Zhou Jun, Wei Jicheng
Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou,Sichuan 646000 , China.
Abstract:
Objective To evaluate the postoperative analgesic efficacy of quadratus lumborum block, fascia iliaca compartment block and no block for total hip arthroplasty.Methods Randomized controlled trials about three analgesia methods in total hip arthroplasty were screened from Pubmed,EMbase,Cochrane-Library and CNKI databases up to July,2020.ADDIS1-16-8 software was conducted to perform network meta-analysis.Results A total of 11studies with 606 patients were enrolled in this study.The rank about postoperative 6~48 h pain scores,24 h morphine consumption and incidence rate of nausea from low to high was that quadratus lumborum block, fascia iliaca compartment block, no block. Conclusion For total hip arthroplasty,quadratus lumborum block can provide better postoperative analgesia, reduce the usage of opioid drugs and occurrence of adverse reaction compared with other methods.Therefore,quadratus lumborum block may be an alternative to postoperative analgesic for total hip arthroplasty.
Key words:  quadratus lumborum block  fascia iliaca compartment block  total hip arthroplasty  postoperative analgesia  network Meta-analysis
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