摘要
目的:探讨超声引导下不同神经阻滞复合全身麻醉在老年膝骨关节炎(knee osteoarthritis,KOA)患者全膝关节置换术(total knee arthroplasty,TKA)中的应用。方法:选取2019年8月—2021年8月暨南大学附属第五医院86例老年KOA患者。根据随机数表法将其分为收肌管阻滞(adductor canal block,ACB)组和髂筋膜间隙阻滞(fascia iliaca compartment block,FICB)组,各43例。两组均择期行TKA治疗,ACB组采用超声引导下ACB复合全身麻醉,FICB组采用超声引导下FICB复合全身麻醉。比较两组术后6 h、术后12 h、术后24 h及术后48 h时疼痛程度,术后6 h内、术后6~12 h、术后12~24 h、术后24~48 h镇痛泵加药次数,术后48 h股四头肌肌力情况。结果:FICB组术后12 h、术后24 h及术后48 h视觉模拟评分法(visual analogue score,VAS)评分均低于ACB组,差异有统计学意义(P<0.05)。FICB组术后6~12 h、术后12~24 h、术后24~48 h镇痛泵加药次数均少于ACB组,差异有统计学意义(P<0.05)。ACB组股四头肌肌力分级优于FICB组,差异有统计学意义(P<0.05)。结论:相较于超声引导下ACB复合全身麻醉,FICB复合全身麻醉更利于降低老年KOA患者术后疼痛程度,减少镇痛泵加药次数,但FICB对股四头肌肌力影响较大。
Objective:To investigate the application of ultrasound-guided different nerve blocks combined with general anesthesia in total knee arthroplasty(TKA)in elderly patients with knee osteoarthritis(KOA).Method:A total of 86 elderly KOA patients in the Fifth Affiliated Hospital of Jinan University from August 2019 to August 2021 were selected.According to the random number table method,they were divided into adductor canal block(ACB)group and fascia iliaca compartment block(FICB)group,43 cases in each group.The ACB group was treated with ultrasonic-guided ACB combined with general anesthesia,and the FICB group was treated with ultrasonic-guided FICB combined with general anesthesia.The degree of pain at 6 h,12 h,24 h and 48 h after operation,the frequency of analgesic pump adding the drug within 6 h,6-12 h,12-24 h and 24-48 h after operation,and the muscle strength condition of quadriceps muscles at 48 h after operation were compared between the two groups.Result:The visual analogue scale(VAS)scores at 12 h,24 h and 48 h after operation in FICB group were lower than those in ACB group,and the differences were statistically significant(P<0.05).The times of analgesic pump adding the drug within 6-12 h,12-24 h and 24-48 h after operation in FICB group were less than those in ACB group,and the differences were statistically significant(P<0.05).The quadriceps muscle strength grading of ACB group was better than that of FICB group,and the difference was statistically significant(P<0.05).Conclusion:Compared with ultrasound-guided ACB combined general anesthesia,FICB combined general anesthesia is more beneficial to reduce the postoperative pain degree of elderly patients with KOA and reduce the times of analgesic pump adding the drug,but FICB has a greater impact on quadriceps muscle strength.
作者
张凤杰
曾畅
ZHANG Fengjie;ZENG Chang(The Fifth Affiliated Hospital of Jinan University,Heyuan 517000,China;不详)
出处
《中外医学研究》
2023年第10期64-67,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
膝骨关节炎
全膝关节置换术
收肌管阻滞
髂筋膜间隙阻滞
疼痛
Knee osteoarthritis
Knee arthroplasty
Adductor canal block
Fascia iliaca compartment block
Pain
