关键词: 纳布啡, 罗哌卡因, 髂筋膜间隙阻滞, 髋部骨折, 术前镇痛

Abstract: Objective To evaluate the effect of nalbuphine used as an adjuvant to ropivacaine during FICB on the duration of preoperative analgesia in patients with hip fracture.Methods eventy elderly patients with hip fracture (femoral neck fracture and intertrochanteric fracture) were selected from Our hospital from March 1, 2020 to December 1, 2020.Random number table method was used to divide them into two groups:ropivacaine group(group L) and nalbuphine combined with ropivacaine group(group N)(n=35 in each).All of the patients received fascia iliaca block inferior to the inguinal ligament soon after admission.Patients in group L received a local anesthetic of 30ml of 0.1% ropivacaine and 2ml of saline while those in group N used local 30ml of 0.1% ropivacaine and 20mg of nalbuphine.The primary outcome measure was the duration of analgesia.Secondary outcomes included sensory block area at 30min,2h,6h,and 8h after block,the number of sleep disturbances by pain,side effects,and the length of stay.Results Compared with group L,the duration of analgesia was significantly prolonged[(9.250±0.465)h vs (6.143±0.851)h，P<0.05],the times of sleep disturbances by pain was lower in group N[0(0,0) vs 0(0,2),P<0.05].There was no difference in the incidence of side effects(0 vs 5.88% for nausea,0 vs 2.94% for vomiting,0 vs 0 for neurological complications,all P>0.05) and llength of stay before surgery[3(2,4) days vs 3(2,4) days for preoperative hospital stay,7(7,9) days vs 8(7,9)days for postoperative hospital stay,both P>0.05].Conclusion Nalbuphine can prolong the duration of analgesia when it was used as an adjuvant to ropivacaine during FICB in patients with hip fractures.

Key words: nalbuphine, ropivacaine, fascia iliac compartment block, hip fracture, preoperative analgesia