超声引导下股神经置管在全膝关节置换术后的镇痛效果  

Ultrasound Guided Analgesic Effect of Femoral Nerve Catheter after Total Knee Arthroplasty

作　　者：彭旭桦[1] PENG Xu-hua(Department of Anesthesiology,the First Affiliated Hospital of Nanping,Fujian Medical University,Nanping,Fujian Province,353000 Chin)

机构地区：[1]福建医科大学附属南平市第一医院麻醉科,福建南平353000

出　　处：《中外医疗》2018年第18期172-174,共3页China & Foreign Medical Treatment

摘　　要：目的探讨超声引导下股神经置管用于全膝关节置换术后的镇痛效果。方法纳入的观察对象为方便选取2015年3月—2017年9月该院的56例行全膝关节置换术后给于镇痛的患者,随机分为A组(镇痛泵持续静脉镇痛),B组(超声引导下置管连续股神经阻滞镇痛),各28例,比较两组患者的疼痛视觉模拟评分(VAS评分)、镇痛效果、患肢关节活动度以及不良反应发生情况。结果 B组术后8、12、24、48 h安静状态下;术后48 h在功能锻炼状态下的VAS评分均明显低于A组(t=9.447、10.435、4.224、6.446、9.256,P<0.05)。A组患者术后24、48 h时的患肢主动关节屈曲角度明显小于B组(t=2.926、16.677,P<0.05),B组患者的不良事件发生率7.1%明显低于A组的50.0%(χ~2=31.06,P<0.01)。结论超声引导下股神经置管用于全膝关节置换术后镇痛,明显缓解患者术后疼痛,增大了患肢关节屈曲角度,降低不良事件发生率,有利于患者的快速康复。Objective This paper tries to observe the analgesic effect of ultrasound-guided femoral nerve catheterization after total knee arthroplasty. Methods The included subjects were 56 patients who underwent total analgesia after total knee arthroplasty in the hospital from March 2015 to September 2017. They were selected conveniently and randomly divided into group A（analgesic pump continuous intravenous analgesia）, group B（Ultrasound guided anesthesia with continuous femoral nerve block）, 28 cases in each group. The visual analog scale score（VAS score）, analgesic effect, joint mobility, and occurrence of adverse reactions were compared between the two groups. Results In group B, the VAS scores at the 8, 12,24, 48 h were lower than those of group A at 48 h postoperatively（t=9.447, 10.435, 4.224, 6.446, 9.256 P〈0.05）. In group A, the active joint flexion angle of the affected limb was significantly lower than that of group B at 24 h and 48 h after operation（t=2.926,16.677,P〈0.05）. The incidence of adverse events in group B was significantly higher of 7.1% was significantly lower than that in group A（50.0%）（χ~2=31.06, P〈0.01）. Conclusion Ultrasound-guided femoral nerve catheterization is used for analgesia after total knee arthroplasty, which significantly relieves postoperative pain, increases the flexion angle of the affected limb, reduces the incidence of adverse events, and is beneficial to the patient＇s rapid recovery.

关 键 词：超声引导下 全膝关节置换术 股神经阻滞 镇痛 

分 类 号：R614[医药卫生—麻醉学]