连续腰丛神经阻滞或连续股神经阻滞用于全膝关节置换术后镇痛的比较  

Effects of continuous lumbar plexus blocks or continuous femoral nerve blocks on postoperative analgesia in total knee arthroplasty

作　　者：赵峰[1] 王丹丹[1] 杨光[1] 黄礼兵[1] 杨程[1] 崔苏扬[1] 

机构地区：[1]南京中医药大学附属医院麻醉科,南京市210029

出　　处：《临床麻醉学杂志》2013年第2期152-154,共3页Journal of Clinical Anesthesiology

摘　　要：目的比较连续腰丛神经阻滞或连续股神经阻滞对全膝关节置换术后镇痛的效果。方法 50例择期腰麻下行单侧全膝关节置换的患者使用神经刺激器引导,随机均分为连续腰丛神经阻滞组(CLPB组)和连续股神经阻滞组(CFNB组)。术后镇痛负荷剂量0.2%罗哌卡因0.4ml/kg,背景剂量0.2%罗哌卡因5ml/h,冲击剂量2ml/15min,保留镇痛48h。记录术后6、12、24、48h时静息状态VAS评分,术后24、48h膝关节功能锻炼时VAS评分和肌力评分。结果 CLPB组术后各时点静息状态和功能锻炼VAS评分均明显低于CFNB组(P<0.05),肌力评分两组间差异无统计学意义。两组术后镇痛期间均无明显不良反应。结论连续腰丛神经阻滞对于全膝关节术后镇痛的临床效果优于连续股神经阻滞。Objective To compare the clinical analgesic effects of continuous lumbar plexus blocks （CLPB） and continuous femoral nerve blocks （CFNB） in patients undergoing total knee arthroplasty （TKA）. Methods Fifty patients undergoing TKA surgeries were randomly assigned to receive CLPB or CFNB. The continuous nerve blocks were guided with electronic nerve stimulator and the nerve block catheters were inserted 8-12 cm. Patients recieved PCA after the surgery. The loading dose was 0.2% ropivacaine 0.4 ml/kg, background dose was 5 ml/h, bolus dose was 2 ml and the locking time was 15 rain. VAS pain scores during rest were recorded at 6, 12, 24, 48 h postoperatively. VAS pain scores during functional excise and muscular strength were recorded at 24, 48 h postoperatively. Results The VAS during rest and functional excise after operation in group CLPB was significantly lower than those in group CFNB. There was no significant difference about muscle strength between the two groups. There was no serious side effect during postoperative analgesia. Conclusion For the TKA analgesia, CLPB had better analgesic effect than CFNB.

关 键 词：连续腰丛神经阻滞 连续股神经阻滞 全膝关节置换 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]