连续股神经阻滞镇痛与静脉自控镇痛在全膝关节置换术后患者中的应用效果比较  

Comparison of application effects of continuous femoral nerve block analgesia and patient-controlled intravenous analgesia in patients after total knee arthroplasty

作　　者：蔡雪梅 CAI Xuemei(Department of Anesthesiology of Qingyuan District People’s Hospital,Ji’an 343000 Jiangxi,China)

机构地区：[1]吉安市青原区人民医院手术室麻醉科,江西吉安343000

出　　处：《中国民康医学》2024年第6期133-135,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较连续股神经阻滞镇痛与静脉自控镇痛在全膝关节置换术后患者中的应用效果。方法:选取2018年12月至2023年3月该院收治的65例全膝关节置换术患者进行前瞻性研究,按照随机数字表法将其分为研究组33例与对照组32例。对照组术后采用静脉自控镇痛,研究组术后采用连续股神经阻滞镇痛,比较两组视觉模拟评分法(VAS)评分、膝关节最大屈曲度和术后谵妄发生率。结果:术后12、24、48 h,研究组静息状态下VAS评分均低于对照组,差异有统计学意义(P<0.05);术后1、3、7 d,研究组主动、被动膝关节最大屈曲度均大于对照组,差异有统计学意义(P<0.05);术后7 d,研究组谵妄发生率为3.03%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论:连续股神经阻滞镇痛用于全膝关节置换术后患者可增大其膝关节最大屈曲度,降低VAS评分和谵妄发生率,效果优于静脉自控镇痛。Objective:To compare application effects of continuous femoral nerve block analgesia and patient-controlled intravenous analgesia in patients after total knee arthroplasty.Methods:A prospective study was conducted on 65 patients with total knee arthroplasty admitted to the hospital from December 2018 to March 2023.According to the random number table method,they were divided into study group(33 cases)and control group(32 cases).The control group was treated with intravenous controlled analgesia after the surgery,while the study group was treated with continuous femoral nerve block analgesia after the surgery.The visual analogue scale(VAS) score,the maximum flexion of knee joint,and the incidence of postoperative delirium were compared between the two groups.Results:12,24 and 48 h after the surgery,the VAS scores in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).1,3 and 7 days after the surgery,the maximum flexion levels of active and passive knee joints in the study group were greater than those in the control group,and the differences were statistically significant(P<0.05).Further,7 days after the surgery,the incidence of delirium in the study group was 3.03%,which was significantly lower than 25.00% in the control group,the difference was statistically significant(P<0.05).Conclusions:Continuous femoral nerve block analgesia for the patients after total knee arthroplasty can increase the maximum flexion of the knee joint,reduce the pain VAS scores and the incidence of delirium.Moreover,it is superior to patient-controlled intravenous analgesia.

关 键 词：连续股神经阻滞镇痛 静脉自控镇痛 全膝关节置换术 膝关节最大屈曲度 谵妄 

分 类 号：R614.4[医药卫生—麻醉学]