连续髂筋膜神经阻滞超前镇痛与股神经阻滞麻醉的效果对比  

Effect of continuous iliac fascia nerve block analgesia and femoral nerve block anesthesia

作　　者：刘红[1] 刘耀森[1] 于中军[2] 戚学琴 王秋筠[3] 

机构地区：[1]青县人民医院麻醉科,河北青县062650 [2]南皮县人民医院麻醉科,河北南皮县061500 [3]河北医科大学第三医院麻醉科,河北石家庄050051

出　　处：《西部医学》2015年第5期677-679,共3页Medical Journal of West China

基　　金：国家自然科学基金(30972832)

摘　　要：目的对比连续髂筋膜神经阻滞超前镇痛与股神经阻滞麻醉在全膝关节置换术(TKA)病人术后的镇痛效果,以探讨连续髂筋膜神经阻滞超前镇痛的安全性及有效性。方法选取2010年5月至2014年4月行TKA的92例患者作为研究对象,采用随机数字表法平均分为观察组和对照组;观察组行连续髂筋膜神经阻滞,对照组行股神经阻滞麻醉;分析两组术后6、12、24、48h静息状态和术后24、48h功能锻炼时视觉模拟评分(VAS),以及麻醉相关不良反应发生情况,对连续髂筋膜神经阻滞超前镇痛的安全性及有效性进行评价。结果观察组术后6、12、24、48hVAS评分和术后24、48h功能锻炼时VAS评分均明显低于对照组,差异具有统计学意义(P<0.05)。观察组与对照组在恶心呕吐、低血压、血管损伤、后腹膜积气、神经损伤等相关不良反应发生情况方面差异不具有统计学意义(P>0.05)。结论连续髂筋膜间隙神经阻滞的镇痛效果明显优于连续股神经阻滞麻醉,且并发症发生率较低,是一种安全有效的镇痛方式,值得临床推广使用。Objective To observe and compare the effect of continuous iliac fascia nerve block analgesia and femoral nerve block anesthesia and discuss the safety and efficacy of continuous iliac fascia nerve block analgesia. Methods 96 total knee arthroplasty patients treated were randomly divided into observation group and control group by random number table method. The observation group received continuous iliac fascia nerve block analgesia. The control group re- ceived femoral nerve block anesthesia. VAS score of resting state 6h, 12h, 24h, 48h after the operation and the VAS score of functional exercise 24h, 48h after the operation and the anesthesia-related adverse reactions were observed. Results The observation group were significantly lower than the control group in resting state VAS score 6h, 12h, 24h, 48 h after the operation. The observation group were significantly lower than the control group in functional exercise VAS score 24h, 48h after the operation, and the difference were statistically significant （P〈0.05）. The observation group and control group had no significant difference in the nausea, vomiting, hypotension-related adverse reactions, vas- cular injury, retroperitoneal product gas, nerve injury, and so on （P〉0.05）. Conclusion Continuous iliac fascia nerve block analgesia is a safe and effective analgesia. The effect of continuous iliac fascia nerve block analgesia is better than that of femoral nerve block anesthesia.

关 键 词：髂筋膜神经阻滞 股神经阻滞 全膝关节置换术 超前镇痛 安全性 有效性 

分 类 号：R614.27[医药卫生—麻醉学]