连续股神经阻滞镇痛在TKA术后康复锻炼中的应用初探  

Exploration of the application of continuous analgesia for femoral nerve block in the rehabilitation process after total knee arthroplasty

作　　者：彭建光[1] 沈惠良[1] 曹光磊[1] 

机构地区：[1]首都医科大学宣武医院骨科,北京100053

出　　处：《中国骨肿瘤骨病》2011年第6期547-549,共3页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的探讨在全膝关节置换术后康复锻炼中连续股神经阻滞镇痛的影响。方法 2009年10月至2010年12月,在我科接受单侧初次TKA手术的患者40例,随机分为连续股神经阻滞镇痛(CFNB)组和静脉镇痛(CIA)组,每组20例。两组采用相同的手术技术和康复锻炼方法。记录住院时间;术后第1、2天康复锻炼前后的疼痛评分,即静息疼痛评分和活动疼痛评分;术后第2、7天康复锻炼结束后膝关节的主动活动度。结果 CFNB组的镇痛评分在静息和活动情况下均比CIA组显著低(P<0.01)。膝关节主动活动度,术后第2天CFNB组与CIA组比较显著增大(P<0.01),术后第7天两组角度差异无显著性(P=0.127)。CFNB组的住院时间显著缩短(P=0.044)。结论全膝关节置换术后,连续股神经阻滞可提供满意的镇痛效果进行康复锻炼,缩短住院日。Objective To discuss the influence of continuous analgesia for femoral nerve block in the rehabilitation process after total knee arthroplasty. Methods 40 patients the first time undergoing unilateral TKA surgery from October 2009 to December 2010 were randomly divided into the group of continuous analgesia for femoral nerve block and the group of intravenous analgesia. Each group included 20 patients, All patients received the same operative technique and rehabilitation strategy. Hospital stays were noted. On the first and second day after the surgery, visual analogue scale （VAS） scores such as pain scores at rest and activity pain scores were assessed before and during rehabilitation. On the second and seventh day, knee active range of motion （ROM） after rehabilitation were recorded. Results VAS scores in the group of continuous analgesia for femoral nerve block at rest and during rehabilitation is obviously lower than the group of intravenous analgesia （P〈0.01）. ROM in the group of continuous analgesia for femoral nerve block was significantly improved than the group of intravenous analgesia on the second day postoperatively （P〈0.01）. On the seventh day, no significant difference of motion range existed （P=0.127）. The hospital stays of continuous analgesia for femoral nerve block group were obviously shortened （P--0.044）. Conclusions After TKA, continuous analgesia for femoral nerve block provides satisfactory effect to facilitate rehabilitation and shorten hospital stays.

关 键 词：全膝关节置换 连续股神经阻滞 术后镇痛 康复 

分 类 号：R614[医药卫生—麻醉学]