摘要
目的探讨超声引导下股神经阻滞联合鸡尾酒疗法用于膝关节术后的镇痛效果,为临床诊疗提供指导。方法选取2018年4月至2019年8月于北京市中关村医院行膝关节术的患者89例进行研究,按照随机数表法将患者分为两组。观察组45例在超声引导下采用股神经阻滞联合鸡尾酒疗法进行术后镇痛,对照组44例则仅给予股神经阻滞镇痛。比较两组患者治疗后各时点静止状态、被动运动状态下的视觉模拟评分法(VAS评分)、膝关节学会评分系统(KSS评分)、膝关节最大伸直度及最大屈曲度,以及两组患者的不良反应发生情况。结果观察组和对照组患者术后静止状态VAS评分术后2 h[(0.72±0.12)分vs(1.12±0.29)分]、6 h[(0.90±0.21)分vs(1.41±0.32)分]、12 h[(1.46±0.31)分vs(2.35±0.54)分]、24 h[(2.41±0.62)分vs(3.02±0.87)分]及48 h[(1.67±0.43)分vs(2.52±0.71)分]比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组和对照组患者术后被动运动状态下的VAS评分术后2 h[(1.51±0.33)分vs(2.39±0.54)分]、6 h[(1.89±0.52)分vs(2.77±0.81)分]、12 h[(2.53±0.59)分vs(3.38±0.83)分]、24 h[(2.49±0.64)分vs(3.11±0.83)分]及48 h[(1.91±0.33)分vs(2.65±0.79)分]比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);两组患者术后2周、1个月、3个月及6个月KSS评分、膝关节最大伸直度、最大屈曲度比较,差异均无统计学意义(P>0.05);观察组患者术后不良反应发生率为15.56%,明显低于对照组的40.91%,差异有统计学意义(P<0.05)。结论超声引导下股神经阻滞联合鸡尾酒疗法用于膝关节术后镇痛效果显著,其可明显降低不良反应发生率,提高治疗安全性,值得临床推广应用。
Objective To explore the analgesic effect of ultrasound-guided femoral nerve block combined with cocktail therapy in knee joint surgery,and to provide guidance for clinical diagnosis and treatment.Methods A total of89 patients,who underwent knee arthroplasty in Beijing Zhongguancun Hospital from April 2018 to August 2019 were selected and divided into two groups according to random number table method.Forty-five patients in the observation group were treated with ultrasound-guided femoral nerve block combined with cocktail therapy,and 44 patients in the control group were only treated with femoral nerve block analgesia.After the treatment,the Visual Analogue Scale(VAS),the Knee Society Score(KSS),the maximum knee straightness,and maximum flexion of the two groups of patients at rest and passive movement were compared at each time point,and the occurrence of adverse reactions in the patients was also analyzed.Results After the treatment,the VAS score of the patients in observation group at rest 2 hours,6 hours,12 hours,24 hours,and 48 hours were(0.72±0.12)points,(0.90±0.21)points,(1.46±0.31)points,(2.41±0.62)points,and(1.67±0.43)points,respectively,which were significantly lower than corresponding(1.12±0.29)points,(1.41±0.32)points,(2.35±0.54)points,(3.02±0.87)points,(2.52±0.71)points of the control group(all P<0.05);the VAS scores of the patients in the observation group in the passive exercise state 2 hours,6 hours,12 hours,24 hours,and 48 hours were(1.51±0.33)points,(1.89±0.52)points,(2.53±0.59)points,(2.49±0.64)points,(1.91±0.33)points,respectively,which were significantly lower than corresponding(2.39±0.54)points,(2.77±0.81)points,(3.38±0.83)points,(3.11±0.83)points,(2.65±0.79)points of the patients in the control group(all P<0.05).There were no significant difference in KSS score,maximum knee extension and maximum flexion between the two groups at 2 weeks,1 month,3 months and 6 months after operation(all P>0.05).The incidence of adverse reactions in the observation group was 15.56%,which
作者
高振意
井凤云
梁晓初
GAO Zhen-yi;JING Feng-yun;LIANG Xiao-chu(Department of Anesthesiology,Beijing Zhongguancun Hospital,Beijing 100080,CHINA)
出处
《海南医学》
CAS
2020年第5期625-628,共4页
Hainan Medical Journal
关键词
股神经阻滞
鸡尾酒疗法
膝关节
术后镇痛
超声引导
效果
Femoral nerve block
Cocktail therapy
Knee joint
Postoperative analgesia
Ultrasound-guided
Effect
