超声引导下收肌管阻滞与大腿远端连续隐神经阻滞复合全身麻醉在膝关节镜手术患者中的效果对比  

Comparison of the Effect of Ultrasound-guided Adductor Canal Block and Distal Thigh Continuous Saphenous Nerve Block Combined with General Anesthesia in Patients Undergoing Knee Arthroscopic Surgery

作　　者：陈振华 陈永强 CHEN Zhenhua;CHEN Yongqiang(Fuqing City Hospital Affiliated to Fujian Medical University,Fuqing 350300,China;不详)

机构地区：[1]福建医科大学附属福清市医院,福建福清350300

出　　处：《中外医学研究》2023年第16期166-169,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:对比超声引导下收肌管阻滞与大腿远端连续隐神经阻滞复合全身麻醉在膝关节镜手术患者中的应用效果。方法:选择2020年4月—2022年4月于福建医科大学附属福清市医院行膝关节镜手术的130例患者纳入此研究,以随机数表法分为A、B两组,各65例。A组行超声引导下收肌管阻滞复合全身麻醉,B组行超声引导下大腿远端连续隐神经阻滞复合全身麻醉。以视觉模拟评分法(VAS)评估两组术后6 h、12 h、24 h的静息状态下的疼痛程度;比较两组术前、术后24 h膝关节屈、伸肌峰力矩(PT);比较两组术前及术后6 h、12 h、24 h的起立行走试验(TUGT)完成时间。结果:术后6 h、12 h、24 h,两组VAS评分比较,差异无统计学意义(P>0.05);术后24 h,B组膝关节屈、伸肌PT均大于A组,差异有统计学意义(P<0.05);术后6 h、12 h、24 h,B组TUGT测试完成时间均短于A组,差异有统计学意义(P<0.05)。结论:超声引导下收肌管阻滞及大腿远端连续隐神经阻滞复合全身麻醉均可为膝关节镜手术患者提供等效的术后镇痛效果,但后者对患者膝关节肌肉功能及运动能力的影响较小。Objective:To compare the application effect of ultrasound-guided adductor canal block and distal thigh continuous saphenous nerve block combined with general anesthesia in patients undergoing knee arthroscopic surgery.Method:A total of 130 patients who underwent knee arthroscopic surgery in Fuqing City Hospital Affiliated to Fujian Medical University from April 2020 to April 2022 were included in this study.They were divided into group A and group B by random number table method,with 65 cases in each group.Group A received ultrasound-guided adductor canal block combined with general anesthesia,while group B received ultrasoundguided distal thigh continuous saphenous nerve block combined with general anesthesia.The degree of pain in both groups at rest at 6 h,12 h,and 24 h after surgery were evaluated by visual analog scale(VAS),the peak torque(PT)of knee joint flexor and extensor muscles between the two groups before and 24 h after surgery were compared,the completion time of timed up and go test(TUGT)between the two groups before and at 6 h,12 h,and 24 h after surgery were compared.Result:There were no statistical significant differences in VAS scores between the two groups at 6 h,12 h and 24 h after surgery(P>0.05).At 24 h after surgery,the PT of flexor and extensor muscles in group B were higher than those in group A,and the differences were statistically significant(P<0.05).At 6 h,12 h and 24 h after surgery,the completion time of TUGT test in group B was shorter than those in group A,and the difference was statistically significant(P<0.05).Conclusion:Ultrasound-guided adductor canal block and distal thigh continuous saphenous nerve block combined with general anesthesia can provide equivalent postoperative analgesia effect for patients undergoing knee arthroscopic surgery,but the latter has smaller impact on knee muscle function and athletic ability.

关 键 词：超声引导 收肌管阻滞 隐神经阻滞 膝关节手术 术后镇痛 运动能力 

分 类 号：R614[医药卫生—麻醉学]