摘要
背景:近年来连续股神经阻滞在人工全膝关节置换过程中广为使用,但是临床上对于该镇痛模式的效果尚存在较大的争议。目的:对比连续股神经阻滞和常规静脉自控镇痛方法在人工全膝关节围置换期的镇痛的效果。方法:纳入南京医科大学附属淮安第一医院骨科2014年1月至2015年1月收治的单侧人工全膝关节置换患者50例,原发病均为膝关节骨关节炎。按随机数字表法分为两组,对照组采用静脉自控镇痛,试验组采用连续股神经阻滞镇痛。对比观察两组患者置换后的疼痛目测类比评分、不良反应及镇痛满意度评分等。结果与结论:试验组患者置换后4,12,24,48,72 h目测类比评分均显著低于对照组(P<0.05)。试验组置换后48-72 h内镇痛辅助药物应用率为4%,显著低于对照组24%(P<0.05)。试验组并发症发生率为12%,显著低于对照组48%(P<0.05);试验组置换后镇痛满意率为88%,显著高于对照组60%(P<0.05)。试验组置换后2,3,4 d及出院时的患肢膝关节活动度均显著大于对照组(P<0.05);试验组置换后住院时间显著短于对照组(P<0.05)。提示连续股神经阻滞多模式镇痛在人工全膝关节围置换期镇痛效果理想,不良反应发生率低,患者满意度高,是人工全膝关节置换后理想的镇痛方案。
BACKGROUND：In recent years, continuous femoral nerve block has been extensively used in total knee replacement, but there has a great dispute on the effect of analgesic mode in the clinic. OBJECTIVE：To compare the analgesic effects of continuous femoral nerve block and conventional intravenous patient-control ed analgesia in total knee arthroplasty. METHODS：A total of 50 cases treated with unilateral total knee arthroplasty in the Department of Orthopedics, Huaian First Hospital Affiliated to Nanjing Medical University from January 2014 to January 2015 were enrol ed in this study. Primary disease was osteoarthritis of the knee. They were randomly divided into two groups. Patients in the control group received intravenous patient-control ed analgesia, and those in the test group received continuous femoral nerve block analgesia. Postoperative pain Visual Analog Scale scores, adverse reactions and analgesic satisfaction score were compared between the two groups. RESULTS AND CONCLUSION：The Visual Analog Scale scores were significantly lower in the test group than in the control group at 4, 12, 24, 48 and 72 hours after surgery （P〈0.05）. The application rate of analgesic adjuvant drugs within 48-72 hours after surgery was significantly lower in the test group （4%） than in the control group （24%） （P〈0.05）. The incidence of complications was significantly lower in the test group （12%） than in the control group （48%） （P〈0.05）. The postoperative analgesic satisfaction rate was significantly higher in the test group （88%） than in the control group （60%） （P〈0.05）. Range of motion of the affected knee was significantly bigger in the test group than in the control group at 2, 3 and 4 days after replacement （P〈0.05）. Length of stay was significantly shorter in the test group than in the control group after surgery （P〈0.05）. These results suggest that multimodal continuous femoral nerve block analgesia has an ideal analgesic effect in total knee replacement. The incidence of adverse reactions is low. The analgesic satisfaction rate is high. Thus, it is an ideal analgesic method after total knee replacement.
出处
《中国组织工程研究》
CAS
北大核心
2015年第48期7736-7740,共5页
Chinese Journal of Tissue Engineering Research
基金
南京医科大学科技发展基金面上项目(2010NJMU122)~~
