膝关节单髁置换中鸡尾酒疗法联合股神经阻滞的镇痛效果  

Analgesic effect of cocktail therapy combined with femoral nerve block in unicompartmental knee arthroplasty

作　　者：王国梁 裴方 彭大霖 金王亦 闫梓文 周屾 王远 郭开今 Wang Guoliang;Pei Fang;Peng Dalin;Jin Wangyi;Yan Ziwen;Zhou Shen;Wang Yuan;Guo Kaijin(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院,江苏省徐州市221000

出　　处：《中国组织工程研究》2024年第30期4831-4836,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:随着微创理念的进一步深入,膝关节单髁置换已成为膝骨关节炎的重要治疗手段,然而,置换后早期疼痛影响其康复进程,因此采取有效的镇痛措施十分必要。股神经阻滞和鸡尾酒疗法是目前膝关节单髁置换的常见镇痛方法,但二者联合应用的镇痛效果及安全性尚缺乏相关研究证实。目的:探究膝关节单髁置换过程中鸡尾酒疗法联合股神经阻滞的镇痛效果。方法:选取2021年10月至2023年1月接受膝关节单髁置换治疗的100例患者作为研究对象,采用随机数字表法将患者分为对照组(n=50)、研究组(n=50)。在膝关节单髁置换过程中,对照组采取股神经阻滞,研究组采取鸡尾酒疗法合并股神经阻滞,对比观察两组患者的镇痛效果、置换后2 d内注射地佐辛止痛频次、患侧膝关节活动度、KSS功能评分以及术后不良反应的发生情况。结果与结论:①研究组置换后12,24,48 h的静息和活动后目测类比评分均低于对照组(P<0.05);②研究组置换后2 d内注射地佐辛止痛频次少于对照组(P<0.05);③研究组置换后1,3 d的膝关节活动度均大于对照组(P<0.05),而两组置换后14 d的活动度比较差异无显著性意义(P>0.05);④研究组置换后2周的膝关节KSS评分大于对照组(P<0.05),而置换后6周至6个月,两组的膝关节KSS评分差异无显著性意义(P>0.05);⑤两组患者置换后14 d内的不良反应发生情况差异无显著性意义(P>0.05);⑥结果表明,在膝关节单髁置换过程中采用鸡尾酒疗法联合股神经阻滞,能明显降低患者的疼痛程度,提高镇痛效果,减少镇痛药物使用频次,改善患者早期膝关节活动度。BACKGROUND:With the further development of minimally invasive concepts,unicompartmental knee arthroplasty has become an important treatment for osteoarthritis of the knee;however,early postoperative pain adversely affects the recovery process,so effective analgesic measures are necessary.Femoral nerve block and cocktail therapy are common analgesic methods for unicompartmental knee arthroplasty,but there is a lack of studies confirming the analgesic effect and safety of their combined application.OBJECTIVE:To investigate the analgesic effect of cocktail therapy combined with femoral nerve block in unicompartmental knee arthroplasty.METHODS:One hundred patients who received unicompartmental knee arthroplasty from October 2021 to January 2023 were selected as the study subjects.They were divided into a control group(n=50)and a study group(n=50)using a random number table method.The femoral nerve block was used in the control group,while cocktail therapy combined with femoral nerve block was used in the study group during unicompartmental knee arthroplasty.Postoperative analgesia effect,analgesic frequency of dezocine injection within 2 days after surgery,motion range of affected knee joint,KSS function scores,and the occurrence of postoperative adverse reactions were compared between the two groups.RESULTS AND CONCLUSION:(1)Visual analog scale scores in the study group were lower than those in the control group at 12,24,and 48 hours after surgery(P<0.05).(2)The analgesic frequency of dezocine in the study group was less than that in the control group within 2 days after surgery(P<0.05).(3)The motion range in the study group was higher than that in the control group 1 and 3 days after surgery(P<0.05).On day 14 after surgery,there was no significant difference in motion range between the two groups(P>0.05).(4)The knee KSS score in the study group was higher than that in the control group at 2 weeks after surgery(P<0.05).There was no statistically significant difference in knee KSS scores between the two groups from 6

关 键 词：膝关节单髁置换 鸡尾酒疗法 股神经阻滞 镇痛效果 膝关节活动度 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687.4