股神经阻滞联合关节腔内注射用于膝关节置换术后镇痛的疗效观察  

Postoperative analgesia efficacy of femoral nerve block combined with intra-articular injection of ropivacaine in patients with knee joint replacement

作　　者：李志斌[1] 祖静涛 韩奕[3] 

机构地区：[1]河北省邯郸市中医院肛肠外科,056001 [2]定州市第二医院麻醉科,073000 [3]河北医科大学第三医院医务处,050051

出　　处：《实用疼痛学杂志》2013年第5期367-370,共4页Pain Clinic Journal

摘　　要：目的 观察术前股神经阻滞联合手术结束前关节腔内注射罗哌卡因用于膝关节置换术后镇痛的效果.方法 气管插管全身麻醉下行膝关节置换术患者60例,随机分为静脉镇痛组（V组）、股神经阻滞组（F组）及股神经阻滞与关节腔内注射联合组（FN组）,每组20例.术后观察镇痛效果与不良反应.结果 术后8h和12h时FN组VAS评分最低,F组低于V组（P＜0.05）；24 h时FN组最低,F组和V组差异无统计学意义；48 h时3组差异无统计学意义（P＞0.05）.V组发生恶心、呕吐6例.结论 股神经阻滞联合关节腔内注射用于膝关节置换术后镇痛,术后早期镇痛效果优于单纯静脉镇痛和单纯股神经阻滞,且未见明显并发症.Objective To observe the postoperative analgesia efficacy of femoral nerve block combined with intra-articular injection of ropivacaine in patients with knee joint replacement. Meth- ads Sixty patients scheduled for unilateral knee joint replacement were randomly divided into 3 groups （n=20）： group V （postoperative controlled intravenous analgesia）, group F（ femoral nerve block）, and group FN （intra-articular injection of ropivacaine combined with femoral nerve block） VAS and side effects were recorded. Results At 8 h, 12 h after the operation, VAS was the lowest in group FN, and VAS in group F was lower than that in group V （P〈0.05）. At 24 h after the op eration, VAS was the lowest in group FN （P〈0.05）, and there was no significantly difference be- tween group F and V （P〉0.05）. At 48 h after the operation there were no significantly differences among 3 groups. There were six patients with nausea and vomit in group V. Conclusion Compared with intravenous analgesia or femoral nerve block, femoral nerve block combined with intra-articular ropivacaine injection has excellent analgesia efficacy at the 12 h postoperatively in patients with knee joint replacement without obvious side effects.

关 键 词：股神经 神经传导阻滞 注射 关节内 镇痛 关节成形术 置换 膝 

分 类 号：R687.4[医药卫生—骨科学]