摘要
目的探讨术前单次股神经阻滞对老年膝关节置换术患者术后镇痛的效果。方法选择择期拟在全身麻醉下行单侧膝关节置换术老年患者40例,采用随机数字表法将患者分为对照组(C组)和股神经阻滞组(F组),每组20例。2组患者均选择气管插管全身麻醉。F组于麻醉诱导前在神经刺激器引导下行患侧股神经阻滞,单次给予0.5%罗哌卡因20mL,C组不给予任何处理。术毕均使用舒芬太尼自控静脉镇痛,维持VAS评分≤3分,当VAS评分>3分时,静脉注射氟比洛芬酯。分别于术后2、4、8、12、24和48h时行BCS舒适度评分,记录患者术后24h舒芬太尼用量、自控镇痛次数、氟比洛芬酯使用率及术后不良反应发生情况。结果与C组比较,F组患者术后各时点BCS舒适度评分均显著升高,术后24h舒芬太尼用量、自控镇痛次数及氟比洛芬酯使用率均显著减少(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论术前单次股神经阻滞可提高全身麻醉下老年膝关节置换术患者术后镇痛效果,减少术后阿片类镇痛药的用量。
Objective To investigate the effect of preoperative single femoral nerve block on postoperative analgesia in elderly patients undergoing total knee arthroplasty.Methods Forty elderly patients scheduled for unilateral knee replacement surgery under general anesthesia were randomly divided into control group（group C）and femoral nerve block group（group F）,with 20 patients in each group.All patients underwent endotracheal general anesthesia.Patients in group F were given nerve stimulator-guided femoral nerve block before anesthesia induction with 20 mL of 0.5% ropivacaine.Patients in group C received no treatment.After operation,patients received patient-controlled intravenous analgesia（PCIA）with sufentanil,and VAS score ≤ 3 was main-tained.If VAS score〉3,patients were injected with flurbiprofen axetil.The comfort level was e-valuated with Bruggrmann comfort scale（BCS）at 2,4,8,12,24 and 48 hours after operation.The consumption of sufentanil,frequency of patient-controlled analgesia,usage rate of flurbiprofen ax-etil and incidence of adverse reactions were recorded within 24 hours after operation.Results Compared with group C,femoral nerve block increased the comfort level and decreased the con-sumption of sufentanil,frequency of patient-controlled analgesia and usage rate of flurbiprofen ax-etil（P 〈0.05）.There was no significant difference in the incidence of postoperative adverse reac-tions between the two groups（P 〉0.05）.Conclusion Preoperative single femoral nerve block can improve postoperative analgesic efficacy and reduce the consumption of opioid analgesics in elderly patients undergoing total knee arthroplasty.
出处
《南昌大学学报（医学版）》
CAS
2014年第8期62-65,共4页
Journal of Nanchang University：Medical Sciences
关键词
股神经
神经传导阻滞
老年人
膝关节置换术
术后镇痛
femoral nerve
nerve block
elderly
total knee arthroplasty
postoperative analgesia
