超声引导下连续收肌管阻滞与股神经阻滞用于全膝关节成形术后镇痛的临床观察

发布时间：2018-05-06 13:20

本文选题：超声引导 + 收肌管阻滞　；参考：《现代医院》2016年11期

【摘要】：目的比较超声引导下连续收肌管阻滞与连续股神经阻滞对全膝关节成形术后镇痛效果。方法选择因创伤性关节炎拟择期行单侧全膝关节成形术的患者50例,随机分为连续股神经阻滞(FNB)组(F组)和连续收肌管阻滞(ACB)组(A组),每组25例,分别接受超声引导下FNB和ACB并留置导管。负荷量为0.5%盐酸罗哌卡因注射液20 m L,术毕持续输注0.2%盐酸罗哌卡因进行术后镇痛(总量100 m L,输注速度2 m L/h)。观察并记录患者术后48 h内股四头肌肌力分级、静息下疼痛评分(VAS)、加用其他镇痛药情况与住院时间、患者满意度以及不良反应。结果两组患者术后股四头肌肌力分级,A组高于F组,差别有统计学意义。静息下疼痛评分(VAS)、加用其他镇痛药情况与住院时间、患者对镇痛治疗的满意度以及不良反应,两组无统计学差异。结论超声引导下连续收肌管阻滞与股神经阻滞相比,可以提供同样的镇痛效果和患者满意度,并降低早期功能锻炼的风险。
[Abstract]:Objective to compare the analgesic effect of continuous adductor canal block and continuous femoral nerve block on total knee arthroplasty. Methods Fifty patients with traumatic arthritis undergoing unilateral total knee arthroplasty were randomly divided into two groups: continuous femoral nerve block (FNBB) group (n = 25) and continuous adductor canal block (ACBB) group (n = 25). FNB and ACB were received under ultrasound guidance and indwelling catheter. The loading volume was 0.5% ropivacaine hydrochloride injection 20 mL, the continuous infusion of 0.2% ropivacaine hydrochloride at the end of operation was used for postoperative analgesia (total 100 mL, infusion speed 2 mL / h). To observe and record the muscle strength grade of quadriceps femoris muscle, the pain score under rest and VASA, the condition of other analgesics and hospitalization time, the satisfaction of patients and the adverse reactions. Results the muscle strength grade of quadriceps femoris muscle in group A was higher than that in group F after operation, and the difference was statistically significant. There was no significant difference between the two groups in terms of pain score under rest, addition of other analgesics and hospitalization time, patients' satisfaction with analgesia and adverse reactions. Conclusion Ultrasound-guided continuous adductor block can provide the same analgesic effect and patient satisfaction as compared with femoral nerve block, and reduce the risk of early functional exercise.
【作者单位】：南京中医药大学附属医院常州市中医医院;
【基金】：2015年江苏省常州市卫生和计划生育委员会科研指导性课题
【分类号】：R614

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