摘要
目的比较连续股神经阻滞（CFNB）和静脉镇痛在全膝关节置换（TKA）术后的镇痛效果。方法单侧人工全膝关节置换术的患者60例，随机分为CFNB组（30例）和静脉镇痛组（30例）。两组患者均使用腰麻联合硬膜外麻醉，静脉镇痛组术后采取常规的持续静脉镇痛，CFNB组行连续股神经阻滞镇痛，观察术后2、6、12、24、36、48、72h时患者VAS评分，并观察术前与术后两个月时膝关节HSS评分，评价两组患者的镇痛效果。结果术后各时点CFNB组VAS评分均低于静脉镇痛组（P〈0．05）；术前两组HSS评分比较差异无统计学意义（P〉0．05），术后两个月时CFNB组的疼痛、活动度评分高于静脉镇痛组（P〈0．05）；CFNB组不良反应发生率低于静脉镇痛组（P〈0．05）。结论全膝关节置换术后患者采用连续股神经阻滞镇痛较静脉镇痛效果好，且不良反应少。
Objective To compare the analgesic efficacy of continuous femoral nerve block （CFNB） with intravenous analgesia for patients after total knee arthroplasty （TKA）. Methods Sixty patients underwent unilateral total knee arthroplasty were randomly divided into CFNB group （30 cases） and intravenous anal- gesia group （30 cases）. All the patients in the two groups were received combined spinal and epidural anesthesia. Patients in the intravenous analgesia group received continuous intravenous analgesia postoperatively, while CFNB group received continuous femoral nerve block. VAS was recorded at 2, 6, 12, 24, 36, 48, 72 hours after the surgery and HSS were recorded at pre-operation and 2 months after the surgery to evaluate the analgesic effects. Results VAS in CFNB group was significantly lower than that in intravenous analgesia group at each time point after the operation （P 〈 0.05）. No significant difference was found in HSS between the two groups before the operation （P 〉 0.05）, but pain and activity scores were higher in CFNB group than those in intravenous group at two months after the operation. The incidence of adverse reactions was significantly higher in CFNB group than that in intravenous analgesia group （P 〈 0.05）. Conclusion Continuous femoral nerve block is better than intravenous analgesia for postoperative analgesia in patients after total knee arthroplasty, with less adverse reactions.
出处
《实用疼痛学杂志》
2015年第1期38-41,共4页
Pain Clinic Journal
关键词
股神经
神经传导阻滞
疼痛
手术后
镇痛
患者控制
关节成形术
置换
髋
Femoral nerve
Nerve block
Pain, postoperative
Analgesia, patient- controlled
Arthroplasty, replacement, hip
