2、股骨干骨折患者的鎮(zhèn)痛完善，并且操作簡單易行，安全性高?！娟P(guān)鍵詞】股骨干骨折；股神經(jīng)阻滯；術(shù)前鎮(zhèn)痛ClinicalObservationofPreoperativeAnalgesiaonFemoralShaftFracturewithFemoralNerveBlockAbstract:ObjectivcTostudytheanalgeticeffectoffemoralnerveblockonthepatientswithfreshfemoralshaftfractureswhentheyarebeingmoved
3、beforeoperationandtosolvetheanalgeticproblemofpreoperativepatientsoffracturesinasaferandmoreeffectiveway.MethodsThirtyASAI?IIpatientswithfemoralshaftfractureweredividedatrandomintothreegroupsattheopcratingday:thefirstwereroutinelygivensodiumluminalO.lgintramu
4、scularly;thesecondweregivenmeperidinehydrochloride50mgandpromethazinehydrochloride25mgintramuscularly,andthethirdweretreatedbyfemoralnerveblockusing2%1idocaine15m1.Al1thethreegroupswereperformedtheVASpainscorcingwhenbeingmoved.RcsultsThereweresignificantdiffe
5、renceintheVASscoresamongthethreegroups:theVASscoreofthethirdgroupwasdistinctly1owerthanthatofthesecond,andthescoreofthesecondwasmuch1owerthanthatofthefirst(P<0.01).ConclusionThefemoralneverblockisagoodmethodtothecontrolof1imbpainwhenthepatientswithfemoralshaf
6、tfracturearcbeingmovedbeforeopcration.Additionally,itcanbeusedeasilyandsafely.Keywords:femoralshaftfracture;femoralnerveblock;preoperativeanalgesia外傷病人術(shù)前疼痛的治療還未引起足夠重視，報(bào)道也很少。股骨干骨折病人麻醉前搬動(dòng)或擺麻醉體位時(shí)非常痛苦，為此我們觀察了兩種方法進(jìn)行術(shù)前鎮(zhèn)痛，并勻傳統(tǒng)的術(shù)前準(zhǔn)備進(jìn)行比較淇中，股神經(jīng)阻滯方法簡單易行，鎮(zhèn)痛效果最好。1資料與方法1.1
7、一般資料股骨干骨折病人30例，ASAI?U級(jí)，擇期擬在硬膜外麻醉下行切開復(fù)位內(nèi)固定術(shù)，其中男24例，女6例。年齡16?70歲。根據(jù)入院順序用隨機(jī)數(shù)法分為1.2鎮(zhèn)痛方法I組常規(guī)肌注苯巴比妥0?1g；n組肌注哌替U定50mg，異丙嗪25mg；DI組肌注苯巴比妥0.1g后，用2%利多卡因10ml與0.75%布比卡因5ml混合液行股神經(jīng)阻滯。股神經(jīng)阻滯方法：仰臥，在腹股溝韌帶下方捫及股動(dòng)脈搏動(dòng)，用手指將其推向內(nèi)側(cè)，在其外緣做皮丘，與皮膚呈45°向頭側(cè)刺入，出現(xiàn)異感后回抽無血液，即可注入局麻藥，同時(shí)在穿刺點(diǎn)遠(yuǎn)端加壓［1］。
8、股神經(jīng)阻滯10min后開始搬動(dòng)病人。1?3分別于病房搬動(dòng)時(shí)、手術(shù)室搬動(dòng)時(shí)、擺麻醉體位時(shí)進(jìn)行視覺模擬評(píng)分（VAS）法，由專人進(jìn)行疼痛評(píng)分，0分為無痛，10分為極度難忍疼痛。1.4統(tǒng)計(jì)分析數(shù)據(jù)以均數(shù)士標(biāo)準(zhǔn)差（士s）表示，組間資料采用t檢驗(yàn)，P<0.05認(rèn)為差異有顯著性。2結(jié)果2.1三組病人年齡、術(shù)前血壓、脈搏，差異無顯著性（P>0.05）。2.2三組病人在病房搬動(dòng)、手術(shù)室搬動(dòng)
