超声引导下闭孔神经阻滞联合连续股神经阻滞在全膝关节置换术后镇痛中的应用效果  

Application effects of ultrasound-guided obturator nerve block combined with continuous femoral nerve block in analgesia after total knee arthroplasty

作　　者：余娟 赵林 陈阳峰 袁亚锋 李会力 YU Juan;ZHAO Lin;CHEN Yangfeng;YUAN Yafeng;LI Huili(Xuchang People’s Hospital,Department of Anesthesiology,Xuchang 461000 Henan,China;Xuchang People’s Hospital,2nd Bone Surgery,Xuchang 461000 Henan,China;Xuchang People’s Hospital,General Surgery,Xuchang 461000 Henan,China)

机构地区：[1]许昌市人民医院麻醉科,河南许昌461000 [2]许昌市人民医院骨外二科,河南许昌461000 [3]许昌市人民医院普外科,河南许昌461000

出　　处：《中国民康医学》2023年第19期65-67,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察超声引导下闭孔神经阻滞联合连续股神经阻滞在全膝关节置换术(TKA)后镇痛中的应用效果。方法:回顾性分析2019年9月至2022年9月于该院行TKA治疗的70例患者的临床资料,根据镇痛方式不同将其分为对照组和观察组各35例。两组均顺利完成TKA,对照组术后予以连续股神经阻滞镇痛,观察组在对照组基础上联合超声引导下闭孔神经阻滞镇痛。比较两组术后疼痛[视觉模拟评分法(VAS)]评分、镇痛满意度和不良反应发生率。结果:术后6、12、24 h,观察组静息、运动时VAS评分均低于对照组,差异有统计学意义(P<0.05);术后48 h,两组静息、运动时VAS评分比较,差异均无统计学意义(P>0.05);观察组镇痛满意度为97.14%(34/35),高于对照组的77.14%(27/35),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下闭孔神经阻滞联合连续股神经阻滞可提高TKA术后镇痛效果和患者镇痛满意度,效果优于单纯连续股神经阻滞,且不会增加不良反应。Objective:To observe application effects of ultrasound-guided obturator nerve block combined with continuous femoral nerve block in postoperative analgesia after total knee arthroplasty(TKA).Methods:The clinical data of 70 patients who underwent TKA in the hospital from September 2019 to September 2022 were retrospectively analyzed.According to different analgesic methods,they were divided into control group and observation group,35 cases in each group.TKA was successfully completed in both groups.The control group was given continuous femoral nerve block analgesia after the surgery,while the observation group was given ultrasound-guided obturator nerve block analgesia on the basis of that of the control group.The postoperative pain[visual analogue scale(VAS)]score,the analgesic satisfaction,and the incidence of adverse reactions were compared between the two groups.Results:6,12 and 24 h after the surgery,the VAS scores of the observation group at rest and during exercise were lower than those of the control group,and the differences were statistically significant(P<0.05).48 h after the surgery,there was no statistically significant difference in the VAS scores between the two groups during rest and exercise(P>0.05).The analgesic satisfaction of the observation group was 97.14%(34/35),which was higher than 77.14%(27/35)of the control group,and the difference was statistically significant(P<0.05).Conclusions:Ultrasound-guided obturator nerve block combined with continuous femoral nerve block can improve the analgesic effects and the patient satisfaction after TKA.Moreover,it is superior to simple continuous femoral nerve block,and will not increase the adverse reactions.

关 键 词：全膝关节置换术 超声引导 闭孔神经阻滞 连续股神经阻滞 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]