超声引导下连续股神经阻滞在老年患者行全膝关节置换术后的镇痛效果观察  

Study on the analgesic effect of continuous ultrasound- guided femoral nerve block in elderly patients undergoing total knee arthroplasty

作　　者：薛瑞萍[1] 吴震[1] 王爱民[2] 

机构地区：[1]江苏省江阴市人民医院麻醉科,江苏江阴214400 [2]江苏省苏州市吴中人民医院麻醉科,江苏苏州215128

出　　处：《临床和实验医学杂志》2016年第23期2372-2375,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨超声引导下连续股神经阻滞在老年病人实施全膝关节置换术术后镇痛效果。方法选择首次全膝关节置换术的老年患者共58例,随机分为研究组和对照组各29例,研究组采用超声引导下连续股神经阻滞,对照组采用传统静脉自控镇痛的方式。比较两组术后首次经静脉患者自控镇痛（PCIA）时间和术后48 h膝关节主动屈曲度,术后48 h膝关节被动屈曲90°时的VAS评分,术后0-6 h、6-12 h、12-24 h、24-48 h的舒芬太尼用量,并发症发生率。结果研究组术后首次PCIA时间和术后48 h膝关节主动屈曲度显著高于对照组,研究组术后48 h膝关节被动屈曲90°时的VAS评分显著低于对照组。研究组术后0-6 h、6-12 h、12-24 h、24-48 h的舒芬太尼用量显著低于对照组。两组并发症发生率差异无统计学意义。结论超声引导下连续股神经阻滞在老年病人实施全膝关节置换术术后的镇痛效果较静脉麻醉更好,舒芬太尼使用剂量更少,更有利于患者术后膝关节功能的恢复。Objective To explore the analgesic effect of continuous ultrasound- guided femoral nerve block in elderly patients undergoing total knee arthroplasty. Methods A total of 58 elderly patients with first total knee replacement surgery were collected and randomly divided into study group and control group（ each group with 29 cases）. In the study group,continuous ultrasound- guided femoral nerve block was used,and in the control group,traditional intravenous analgesia was used. The way of analgesic effect was compared. The postoperative first time PCIA and active knee flexion at 48 h after the operation,VAS scores at 90° passive knee flexion at 48 h after the operation,sufentanil dosages at 0 - 6 h,6- 12 h,12 - 24 h and 24 - 48 h after operation and the incidence of complications were compared. Results In the study group,the first time PCIA and active knee flexion after 48 h were significantly higher than those of control group. In the study group,VAS scores at passive knee flexion 90° at 48 h after the operation were significantly lower than those of control group. In the study group,sufentanil dosages at 0 - 6 h,6 - 12 h,12 - 24 h and 24 - 48 h after surgery were significantly lower than those of control group. The complication rates of 2 groups had no statistically significant difference. Conclusion Ultrasound guided continuous femoral nerve block in elderly patients undergoing total knee arthroplasty had better analgesic effect than that of intravenous anesthesia,it had less sufentanil dosage and more conductive to the recovery of knee function in these patients.

关 键 词：全膝关节置换术 超声引导 连续股神经阻滞 镇痛 

分 类 号：R614[医药卫生—麻醉学]