持续收肌管阻滞在全膝关节置换术患者术后镇痛中的应用观察及对患者关节活动度的影响  

Observation on the Application of Continuous Adductor Canal Block in Postoperative Analgesia of Patients Undergoing Total Knee Arthroplasty and Its Impact on Joint Range of Motion

作　　者：朱郧堰 石平 ZHU Yunyan;SHIPing(Anesthesiology Department,Shiyan Hospital of Integrated Chinese and Western Medicine,Shiyan 442000,China;不详)

机构地区：[1]十堰市中西医结合医院麻醉科,湖北十堰442000 [2]湖北文理学院附属医院(襄阳市中心医院)麻醉科,湖北襄阳441021

出　　处：《中国医学创新》2024年第35期97-101,共5页Medical Innovation of China

摘　　要：目的:探究持续收肌管阻滞(continuous adductor canal block,CACB)在全膝关节置换术(total knee arthroplasty,TKA)患者术后镇痛中的应用效果及对患者关节活动度的影响。方法:选取2020年3月—2023年3月十堰市中西医结合医院收治的100例TKA患者。按随机数字表法分为对照组(50例)和观察组(50例),观察组采用CACB镇痛,对照组则采用静脉镇痛。对比两组术后疼痛程度、膝关节活动度、镇痛泵按压及补救镇痛次数、不良反应发生情况。结果:观察组术后6、12、24、48 h活动和静息状态下的视觉模拟评分法(VAS)评分均较对照组低,术后12、24、48、72 h两组膝关节活动度逐渐增加,且观察组术后各时点膝关节活动度均较对照组高,观察组术后72 h内镇痛泵按压、补救镇痛次数均较对照组少,差异均有统计学意义(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:CACB可提高TKA患者术后的镇痛效果,改善患者的关节活动度,且未增加不良反应。Objective:To explore the application effect of continuous adductor canal block(CACB)in postoperative analgesia of patients undergoing total knee arthroplasty(TKA)and its impact on joint range of motion.Method:A total of 100 TKA patients treated in Shiyan Hospital of Integrated Chinese and Western Medicine from March 2020 to March 2023 were selected.They were divided into control group(50 cases)and observation group(50 cases)according to random number table method.The observation group received CACB analgesia,and the control group received intravenous analgesia.Postoperative pain degree,knee joint motion,the number of analgesic pump compression and remedial analgesia,and the occurrence of adverse reactions were compared between the two groups.Result:Visual analog scale(VAS)scores at 6,12,24 and 48 h after operation in the observation group were lower than those in the control group,knee joint motion in both groups gradually increased at 12,24,48 and 72 h after operation,and knee joint motion in the observation group were higher than those in the control group at all time points after operation,the number of analgesic pump compression and relief analgesia in the observation group were less than those in the control group within 72 h after operation,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:CACB can improve the postoperative analgesic effect and joint mobility of TKA patients without increasing adverse reactions.

关 键 词：全膝关节置换术 持续收肌管阻滞 持续静脉镇痛 术后镇痛 关节活动度 

分 类 号：R614[医药卫生—麻醉学]