不同置管方式用于股神经阻滞术后镇痛的效果  

Analgesic efficacy of stimulating catheter of two different methods for continuously postoperative femoral nerve block

作　　者：陶岩[1] 张晓光[1] 廖俊[1] 李露[1] 王庚[1] 岳云[2] 

机构地区：[1]北京积水潭医院麻醉科,100035 [2]北京朝阳医院麻醉科

出　　处：《临床麻醉学杂志》2013年第2期161-163,共3页Journal of Clinical Anesthesiology

摘　　要：目的采用连续刺激导管进行股神经置管,比较膝关节镜术后不同置管方法的镇痛效果。方法选择择期行膝关节镜手术患者80例,随机均分为股神经刺激器引导置管组(RA组)和传统经验置管组(RT组)。两组均采用1.73%碳酸利多卡因连续硬膜外维持术中麻醉,麻醉后置入连续股神经阻滞导管。两组术后经导管持续输注0.2%罗哌卡因5ml/h。观察并记录术后2、6、24、48h静息VAS评分、患者满意度、不良反应及伍用镇痛药情况。结果术后2、6hRA组静息VAS评分明显低于RT组(P<0.01)。术后24h和48h两组静息VAS评分均低于3分,差异无统计学意义。两组患者术后均未出现头痛、恶心、呕吐、尿潴留等不良反应。结论膝关节镜术后2、6h神经刺激器引导置管较传统经验置管静息镇痛效果明显改善,但术后24、48h镇痛效果无显著差别。Objective To compare the analgesic efficacy of two different methods of continuous femoral nerve after knee arthroscopy. Methods Eighty patients for elective knee arthroscopy were assigned to two groups randomly, accurate femoral nerve catheter placement （group RA）and traditional catheter placement（group RT）with 40 cases each. The continuous femoral nerve catheters were placed after the continuous epidural anesthesia was established with 1.73% carbonated lidocaine. After the surgeries, 0.2% ropivacaine 5 ml/h was given through femoral nerve catheter. VAS at rest in postoperative 2,6,24,48 h , satisfaction, side effects and additional analgesic dose were recorded. Results VAS at rest in group RA was lower than group RT at 2, 6 h postoperation signifieantly（P〈0. 01）. There was no significant difference in the VAS at rest and satisfaction between the two groups at 24,48 h postoperatively. There was no headache, nausea and vomiting, urinary retention and other adverse reactions observed in both groups. Conclusion The efficacy of analgesia was improved in group RA significantly at 2 h and 6 h postoperatively when compared with that in group RT, but no difference at 24 h and 48 h postoperatively.

关 键 词：股神经导管 术后镇痛 碳酸利多卡因 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]