超声引导下连续股神经阻滞在老年患者行全膝关节置换术后的镇痛效果观察

发布时间：2018-01-13 03:24

本文关键词：超声引导下连续股神经阻滞在老年患者行全膝关节置换术后的镇痛效果观察　出处：《临床和实验医学杂志》2016年23期 　论文类型：期刊论文

【摘要】：目的探讨超声引导下连续股神经阻滞在老年病人实施全膝关节置换术术后镇痛效果。方法选择首次全膝关节置换术的老年患者共58例,随机分为研究组和对照组各29例,研究组采用超声引导下连续股神经阻滞,对照组采用传统静脉自控镇痛的方式。比较两组术后首次经静脉患者自控镇痛(PCIA)时间和术后48 h膝关节主动屈曲度,术后48 h膝关节被动屈曲90°时的VAS评分,术后0~6 h、6~12 h、12~24 h、24~48 h的舒芬太尼用量,并发症发生率。结果研究组术后首次PCIA时间和术后48 h膝关节主动屈曲度显著高于对照组,研究组术后48 h膝关节被动屈曲90°时的VAS评分显著低于对照组。研究组术后0~6 h、6~12 h、12~24 h、24~48 h的舒芬太尼用量显著低于对照组。两组并发症发生率差异无统计学意义。结论超声引导下连续股神经阻滞在老年病人实施全膝关节置换术术后的镇痛效果较静脉麻醉更好,舒芬太尼使用剂量更少,更有利于患者术后膝关节功能的恢复。
[Abstract]:Objective to investigate the analgesic effect of continuous femoral nerve block guided by ultrasound in elderly patients undergoing total knee arthroplasty. Methods 58 elderly patients undergoing the first total knee arthroplasty were selected. They were randomly divided into two groups: 29 cases in the study group and 29 cases in the control group. The study group was treated with continuous femoral nerve block under the guidance of ultrasound. The control group was treated with traditional patient-controlled intravenous analgesia. The time of PCIA and the active flexion of knee joint 48 hours after operation were compared between the two groups. The VAS score at 90 掳passive flexion of knee joint at 48 h after operation, and the dosage of sufentanil at 6 h, 6 h, 12 h, 1224 h, 24 h, 48 h after operation. Results the first time of PCIA and the degree of active flexion of knee joint in the study group were significantly higher than those in the control group. The VAS score at 90 掳passive flexion of knee joint in the study group was significantly lower than that in the control group at 48 h after operation, and was significantly lower in the study group than that in the control group. 24 / 48. There was no significant difference in the incidence of complications between the two groups. Conclusion the analgesic effect of continuous femoral nerve block under the guidance of ultrasound in elderly patients undergoing total knee arthroplasty is more static. Pulse anesthesia is better. The lower dosage of sufentanil is beneficial to the recovery of knee joint function after operation.
【作者单位】：江苏省江阴市人民医院麻醉科;江苏省苏州市吴中人民医院麻醉科;
【分类号】：R614
【正文快照】： 组。两组并发症发生率差异无统计学意义。结论超声引导下连续股神经阻滞在老年病人实施全膝关节置换术术后的镇痛效果较静脉麻醉更好,舒芬太尼使用剂量更少,更有利于患者术后膝关节功能的恢复。老年或者高龄在过去是全膝关节置换术的禁忌症,但是,随着人口老龄化,行全膝关节置

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