摘要
目的比较三种镇痛方式用于全膝关节置换术(TKA)术后镇痛的临床效果。方法90例行单侧TKA患者随机均分为三组,术后镇痛分别采用连续硬膜外麻醉(CEA组)、连续股神经阻滞(CFNB组)和静脉镇痛(CIA组),评估术前、术后活动和静息状态VAS疼痛评分,测定术后膝关节运动的最大角度,记录患者不良反应发生情况。结果三组术后静息时的VAS疼痛评分均较术前降低(P<0.05)。术后活动时,CFNB组VAS疼痛评分低于CEA组与CIA组(P<0.05);静息时,CEA组和CFNB组VAS疼痛评分低于CIA组(P<0.05)。CFNB组不良反应发生率为6.7%,低于CIA组的33.3%和CEA组的46.7%(P<0.05)。CFNB组主动和被动锻炼角度大于CIA组和CEA组(P<0.05),CEA组主动锻炼角度大于CIA组(P<0.05)。结论 CFNB用于TKA术后镇痛的临床效果优于CEA和CIA,不良反应少。
Objective To compare the efficacy of three postoperative analgesia techniques in the patients after total knee arthroplasty（TKA）.Methods A total of 90 cases undergoing unilateral TKA was equally randomized into three groups and postoperative analgesia was performed with continuous epidural anesthesia（group CEA）,continuous femoral nerve block（group CFNB）or intravenous analgesia（group CIA）.VAS pain score was evaluated under activity and resting status before and after operation.The maximum angle of knee joint movement was measured.The adverse responses were recorded.Results The VAS pain scores at resting status were lower after operation than those before in three groups（P〈0.05）.The VAS pain score after operation at activity status was lower in group CFNB than that in groups of CEA and CIA,which at resting status was lower in groups of CEA and CFNB than that in group CIA（P〈0.05）.The incidence rate of adverse responses was lower in group CFNB than that in groups of CIA and CEA（6.7% vs.33.3% and 46.7%）（P〈0.05）.The angles of knee joint movement at active and passive exercise were greater in group CFNB than those in groups of CIA and CEA（P〈0.05）.The angle of knee joint movement at active exercise was greater in group CEA than that in group CIA（P〈0.05）.Conclusion The efficacy of postoperative analgesia with CFNB is better than that with CEA or CIA with less adverse responses in the patients undergoing TKA.
作者
王凤双
叶永志
WANG Fengshuang;YE Yongzhi(Department of Orthopedics, Taizhou Hospital of Integrated Traditional and Western Medicine, Taizhou 317523, CHINA)
出处
《江苏医药》
CAS
2018年第6期649-651,共3页
Jiangsu Medical Journal
基金
温岭市科技计划项目(2017C311135)
关键词
术后镇痛
全膝关节置换术
Postoperative analgesia
Total knee arthroplasty
