国产连续神经阻滞导管针在全膝关节置换术及术后镇痛的应用  

Application of home-made needle-over-cannula nerve block needle in continuous postoperative analgesia after total knee arthroplasty

作　　者：邹天笑 胡小雪 何苗[1] 蔡光玉 张晓庆[1] 余斌[1] 

机构地区：[1]同济大学附属同济医院麻醉科,上海200065 [2]上海市光华中西医结合医院麻醉科,上海200062

出　　处：《同济大学学报（医学版）》2015年第6期88-93,共6页Journal of Tongji University(Medical Science)

摘　　要：目的通过国产连续神经阻滞导管针与进口连续周围神经阻滞套件在全膝关节置换术后镇痛的随机、单盲、对照临床试验,检验国产连续神经阻滞针的有效性和安全性。方法严格按照入组标准和排除标准选择60例行全膝关节置换术的受试者,完全随机分成进口组(n=30)和国产组(n=30),分别使用国产连续神经阻滞导管针和进口连续周围神经阻滞套件行连续股神经阻滞术后镇痛,比较两组的操作时间、尝试置管次数、不良反应及镇痛效果。结果两组的镇痛效果无明显差异(P>0.05)。国产组留置导管的操作时间明显比进口组短(P<0.05)。进口组中有4例置管失败、12例发生严重的局麻药渗漏,而在国产组中均未发生。结论国产连续神经阻滞导管针可有效、方便、安全的应用于全膝关节置换术后镇痛。Objective To evaluate the efficacy and safety of home-made needle-over-cannula nerve block needle in continuous postoperative analgesia after total knee arthroplasty（ TKA）. Methods Sixty patients undergoing TKA were randomly assigned to use home-made needle-over-cannula nerve block needle（ group A,n = 30） or imported continuous peripheral nerve block catheter set（ group B,n = 30） in continuous femoral nerve block（ CFNB） for postoperative analgesia. The operation time,number of catheter insertion,adverse reaction and analgesic effet of both groups were recorded and compared. Results There were no significant difference in analgesic effect between two groups（ P〉0. 05）. The time consumed for catheter or cannula insertion in group B was longer than that in group A（ P〈0. 05）. There were 4 cases of catheter insertion failure and 12 cases of serious local anesthetics leakage at the puncture site in group B; while none in group A. Conclusion The home-made needle-over-cannula nerve block needle is effective,convenient and safe in continuous femoral nerve block analgesia after TKA.

关 键 词：连续股神经阻滞 术后镇痛 全膝关节置换 

分 类 号：R614[医药卫生—麻醉学]