超声引导下收肌管联合ipAck神经阻滞在膝关节置换术后镇痛中的应用研究  

Study on the application of adductor tube combined with ipAck nerve block under ultrasound guidance in analgesia after knee arthroplasty

作　　者：刘宇权 邬文伟[1] 王军[1] 曾志文[1] 廖亿粦[1] LIU Yuquan;WU Wenwei;WANG Jun;ZENG Zhiwen;LIAO Yiling(Department of Anesthesiology,Meizhou People′s Hospital,Meizhou,Guangdong 514031,China)

机构地区：[1]梅州市人民医院麻醉科,广东梅州514031

出　　处：《现代医药卫生》2021年第9期1465-1467,共3页Journal of Modern Medicine & Health

基　　金：广东省梅州市科技局科技计划项目(2018B017)。

摘　　要：目的探讨超声引导下收肌管联合ipAck神经阻滞用于膝关节置换术后镇痛的临床效果。方法选取该院2018年2月至2019年12月该院收治的行膝关节置换术患者90例,随机分为对照组(45例)和观察组(45例),分别采用超声引导下收肌管阻滞和超声引导下收肌管联合ipAck神经阻滞方案行术后镇痛。比较两组术后48 h疼痛数字评分法11(NRS)静态/动态评分曲线下面积(AUC)、麻醉药物使用情况[舒芬太尼使用量、静脉自控镇痛泵(PCIA)按压率]、下床最多活动步数及主动屈膝最大角度。结果观察组术后48 h NRS静态/动态评分AUC均显著低于对照组;舒芬太尼用量显著少于对照组,差异均有统计学意义(P<0.05)。两组PCIA按压率比较,差异无统计学意义(P>0.05)。观察组术后48 h下床最多活动步数和主动屈膝最大角度均显著多于对照组,差异均有统计学意义(P<0.05)。结论超声引导下收肌管联合ipAck神经阻滞用于膝关节置换术后镇痛可有效缓解患者术后疼痛程度,减少麻醉药物用量,并有助于改善患者早期活动功能。Objective To explore the clinical effect of adductor tube combined with ipAck nerve block under ultrasound guidance in analgesia after knee arthroplasty.Methods A total of 90 patients undergoing knee arthroplasty in the hospital from February 2018 to December 2019 were selected and randomly divided into control group(45 cases)and observation group(45 cases).Adductor tube block under ultrasound guidance and adductor tube combined with ipAck nerve block ultrasound-guided were adopted for postoperative analgesia respectively.The Area under the curve(AUC)of static/dynamic score of numerical pain score 11(NRS),the use of anesthetics[the usage of sufentanil,the compression rate of intravenous patient-controlled analgesia pump(PICA)],the maximum number of steps to get out of bed,and the maximum angle of active knee flexion at 48 hours after the operation were compared between the two groups.Results The AUC of static/dynamic score of NRS at 48 h after operation in the observation group was significantly lower than that in the control group;the dosage of sufentanil in the observation group was significantly less than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the compression rate of PCIA between the two groups(P>0.05).The maximum number of steps to get out of bed and the maximum angle of active knee flexion in the observation group were significantly more than those in the control group at 48 h after operation,and the differences were statistically significant(P<0.05).Conclusion The use of adductor tube combined with ipAck nerve block under ultrasound guidance for postoperative analgesia after knee arthroplasty can effectively relieve postoperative pain,reduce the amount of anesthetics,and help improve the patient′s early mobility.

关 键 词：超声 收肌管阻滞 ipAck神经阻滞 膝关节置换术 镇痛 

分 类 号：R614.3[医药卫生—麻醉学] R614.4[医药卫生—外科学]