超声引导与神经刺激引导下股神经连续阻滞在全膝关节置换中的临床研究（英文）

发布时间：2018-02-27 21:25

本文关键词： 超声神经刺激器连续股神经阻滞全膝关节置换术　出处：《中国矫形外科杂志》2015年03期 　论文类型：期刊论文

【摘要】：[目的]比较不同方式引导下股神经连续阻滞(PCNA)在全膝关节置换术后镇痛效果和并发症及对康复功能的影响。[方法]全身麻醉下行单侧膝关节置换术患者60例,随机分为三组(n=20):超声引导组(U组)、神经刺激仪组(S组)、超声联合神经刺激仪双重引导组(D组),观察3组患者术后的镇痛效果、穿刺成功时间与次数及并发症,术后6、12、24 h及48 h不同时间点VAS评分。[结果]D组和U组成功完成操作的穿刺次数明显少于S组(P0.05),D组和U组比较差异无统计学意义(P0.05);从准备穿刺到完成操作所需的时间三组间比较差异无统计学意义(P0.05)。术后6 h VAS评分,D组优于S组和U组(P0.05),其余各时间点比较三组间差异无统计学意义(P0.05)。术后镇痛泵的按压次数,D组少于U组和S组(P0.05),U组和S组比较差异无统计学意义(P0.05)。术后S组有5例出现穿刺部位皮下淤血,U组和D组无并发症发生。[结论]超声联合神经刺激器技术引导股神经阻滞,其穿刺的安全性和准确性优于单独一项技术的使用,且两种技术的联合操作未见穿刺时间的延长,应用于全膝关节置换术后镇痛有其优越性。
[Abstract]:[objective] to compare the analgesic effect, complications and rehabilitation function of continuous femoral nerve block PCNA guided by different methods after total knee arthroplasty. [methods] Sixty patients with unilateral knee arthroplasty under general anesthesia were treated. Three groups were randomly divided into three groups: group U, group S and group D, respectively. The analgesic effect, the time and times of successful puncture and complications were observed. (results) the puncture times of group D and group U were significantly less than those of group S (P 0.05) and group U (P 0.05). There was no significant difference among the three groups (P 0.05). The VAS score of group D was better than that of group S and group U at 6 hours postoperatively, but there was no significant difference between the three groups at other time points. The times of postoperative analgesia pump in group D were less than those in group U and group S. There was no significant difference between group A (P 0.05) and group S (P 0.05). There were no complications in group S (5 cases) after operation. [conclusion] Ultrasound combined with nerve stimulator can lead to femoral nerve block. The safety and accuracy of the puncture is better than that of a single technique, and the combined operation of the two techniques has no prolongation of the puncture time, so it has its superiority in analgesia after total knee arthroplasty.
【作者单位】：山东省潍坊市人民医院麻醉科;
【分类号】：R614

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