摘要
目的探讨超声引导下两种置管长度连续股神经阻滞对老年膝关节周围骨折术后镇痛效果的影响。方法将全身麻醉下行初次膝关节周围骨折内固定术的老年患者80例随机分为2组,每组40例。术后在手术侧用超声引导下沿股神经分别置入导管2 cm(A组)或10 cm(B组)。比较2组置管侧下肢感觉和运动阻滞起效时间、阻滞成功率、置管操作时间和患者对置管操作的满意度;比较2组术后6、12、24、36、48 h静息状态与功能锻炼时镇痛效果视觉模拟评分(VAS);比较2组需要追加静脉补救镇痛药的例数和次数。结果 2组起效时间、术后镇痛效果、不良反应发生率、追加静脉补救镇痛药的例数和次数等比较,差异无统计学意义(P> 0. 05); A组操作时间短于B组,对操作满意度高于B组,差异有统计学意义(P <0. 05)。结论超声引导下沿股神经置入导管2或10 cm连续阻滞用于老年膝关节周围骨折术后镇痛的效果好,不良反应少,安全性高。
Objective To explore the influence of continuous femoral nerve block by ultrasound-guided catheterization with different lengths on postoperative analgesic effect in elderly patients with periarticular fracture of knee joint. Methods Eighty elderly patients with internal fixation for primary periarticular fracture of knee joint under general anesthesia were randomly divided into two groups, with 40 cases in each group. After the surgery, a 2 cm catheter (group A) or a 10 cm catheter (group B) were inserted along the femoral nerve at the operative side under guidance of ultrasound. The onset time of sensory and motor blocking, success rate of blocking, operation time of catheterization and patients′ satisfaction degree to catheterization were compared between the two groups. Thescores of visual analogue scale (VAS) under resting state and functional exercise at 6, 12, 24, 36 and 48 hours after operation were compared between the two groups. The cases and numbers of patients requiring additional intravenous remedial analgesics were compared between the two groups. Results There were no significant differences in onset time, postoperative analgesic effect, incidence rate of adverse reactions, and cases and numbers of patients requiring additional intravenous remedial analgesics between the two groups ( P >0.05). The operation time of group A was significantly shorter than that of group B, and the satisfaction degree to operation was significantly higher than group B ( P <0.05). Conclusion For elderly patients with periarticular fracture of knee joint, the continuous blocking by catheterization of 2 or 10 cm catheters along the femoral nerve under guide of ultrasound shows an excellent efficiency with the high safety and few adverse reactions.
作者
祝义军
殷勇
冉国
鲍杨
贺广宝
ZHU Yijun;YIN Yong;RAN Guo;BAO Yang;HE Guangbao(Department of Anesthesiology,The Central Hospital of JiadingDistrict in Shanghai, Shanghai 201899;Department of Orthopedics, The Central Hospital of JiadingDistrict in Shanghai, Shanghai 201899)
出处
《实用临床医药杂志》
CAS
2019年第6期116-119,共4页
Journal of Clinical Medicine in Practice
基金
上海市嘉定区科委科研项目资助(KWKYXM 2014-KW-18)
关键词
超声
连续股神经阻滞
置管
膝关节周围骨折
术后镇痛
老年患者
ultrasound
continuous femoral nerve block
catheterization
periarticular fracture of knee joint
postoperative analgesia
elderly patients
