超声引导下收肌管阻滞在小型膝关节镜手术术后镇痛中的应用

发布时间：2018-04-27 20:51

本文选题：收肌管阻滞 + 小型关节镜手术　；参考：《实用医学杂志》2017年05期

【摘要】：目的:探讨超声引导下收肌管阻滞应用于各种小型膝关节镜手术术后镇痛的效果。方法:择期行小型关节镜手术患者60例,随机分为收肌管阻滞组(ACB组)和对照组(C组),每组30例。ACB组患者在手术结束后行超声引导下收肌管阻滞,注入0.5%罗哌卡因20 m L。在术后4、8、12、24 h时应用视觉模拟评分法(VAS)对患肢膝关节部位的静息状态及被动屈膝时的疼痛程度进行评分并记录,同时记录术后24 h下地步行5 m的患者人数,使用哌替啶的次数及总量、发生恶心呕吐、头晕、尿潴留等镇痛相关不良反应的例数。结果:ACB组术后4、8、12 h的静息疼痛和活动疼痛VAS评分低于对照组(P0.01)。术后24 h两组患者均能下床行走5 m,对肌力无明显影响。对照组有4例术后因疼痛需使用镇痛药,其中1例发生恶心呕吐。结论:超声引导下收肌管阻滞应用于小型关节镜手术术后,可以提供良好的镇痛效果,且对肌力无明显影响。
[Abstract]:Objective: to investigate the effect of ultrasonic-guided adductor block on postoperative analgesia of various small knee arthroscopic operations. Methods: sixty patients undergoing mini-arthroscopic surgery were randomly divided into adductor block group (ACB group) and control group (group C). 30 patients in ACB group were treated with ultrasound guided adductor canal block after operation, and 0.5% ropivacaine was injected with 20 mL. Visual analogue score (VAS) was used to evaluate the rest state of the knee joint and the pain degree of passive flexion at 24 h after operation. The number of patients who walked 5 m at 24 h after operation was recorded. The frequency and amount of pethidine use, nausea and vomiting, dizziness, urinary retention and other analgesic related adverse reactions. Results the VAS score of rest pain and active pain in the control group was lower than that in the control group (P 0.01). 24 h after operation, the patients in both groups were able to walk out of bed for 5 m and had no significant effect on muscle strength. In the control group, 4 cases needed analgesics because of postoperative pain, and 1 case developed nausea and vomiting. Conclusion: Ultrasound-guided adductor block can provide good analgesic effect after small arthroscopic surgery, and has no obvious effect on muscle strength.
【作者单位】：兰州大学第二临床医学院;兰州军医总医院;
【基金】：2015年甘肃省自然科学基金项目(编号:1506RJ-ZA305)
【分类号】：R687.4

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