摘要
目的:探讨老年全膝关节置换术患者术后镇痛中超声引导下连续股神经阻滞的应用效果及对患者血流动力学的影响。方法:选取2018年3月-2020年3月126例老年全膝关节置换术治疗的患者,依据术后镇痛方式的不同分为对照组和研究组,每组63例。对照组采用自控静脉镇痛,研究组采用超声引导下连续股神经阻滞。比较两组患者术后2、4、8、12、24、48 h静息时VAS评分、MAP、HR水平及患肢功能恢复情况和不良反应发生情况。结果:研究组术后2、4、8、12、24、48 h静息时VAS评分、MAP、HR均低于对照组,差异均有统计学意义(P<0.05)。研究组术后首次直腿抬高时间和主动屈膝达90°时间均短于对照组,术后24、48 h的膝关节活动度均高于对照组,差异均有统计学意义(P<0.05)。研究组不良反应发生率为4.76%,低于对照组的20.63%,差异有统计学意义(P<0.05)。结论:老年全膝关节置换术患者术后应用超声引导下连续股神经阻滞,镇痛效果明显,降低MAP、HR水平,改善患肢功能恢复情况,且安全性较高,值得广泛推广。
Objective:To investigate the application effect of ultrasound-guided continuous femoral nerve block in postoperative analgesia of elderly patients with total knee arthroplasty and its influence on hemodynamics.Method:A total of 126 elderly patients undergoing total knee arthroplasty from March 2018 to March 2020 were selected,and they were divided into the control group and the study group according to different postoperative analgesia,63 cases in each group.The control group was treated with automatic venous analgesia,while the study group was treated with ultrasound-guided continuous femoral nerve block.VAS scores,MAP,HR of 2,4,8,12,24 and 48 h after surgery in at rest,functional recovery of affected limbs and the incidence of adverse reactions were compared between two groups.Result:VAS scores,MAP,HR of 2,4,8,12,24 and 48 h after surgery in at rest of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).The time of first straight leg raising and active knee flexion up to 90°of the study group were shorter than those of the control group,and the range of motion of knee joint 24 and 48 h after surgery were higher than those of the control group,the differences were statistically significant(P<0.05).The incidence of the adverse reactions of the study group was 4.76%,it was lower than 20.63%of the control group,the difference was statistically significant(P<0.05).Conclusion:The application of ultrasound-guided continuous femoral nerve block after total knee arthroplasty in elderly patients has obvious analgesic effect,reduces MAP and HR levels,and improves the functional recovery of affected limbs,with high safety and worthy of wide promotion.
作者
王芳
WANG Fang(Jiamusi Central Hospital,Jiamusi 154002,China)
出处
《中国医学创新》
CAS
2021年第18期139-142,共4页
Medical Innovation of China
关键词
全膝关节置换术
术后镇痛
超声引导下连续股神经阻滞
Total knee arthroplasty
Postoperative analgesia
Ultrasound-guided Continuous femoral nerve block
