四川医学2017，Vol.38Issue(2)：192-195,4.DOI:10.16252/j.cnki.issn1004-0501-2017.02.020
连续股神经阻滞联合膝关节周围注射在膝关节置换术后镇痛效果观察
The Analgesic Effect of Continuous Femoral Nerve Block Combined with Periarticular Injection of Knee Joint After Knee Arthroplasty
殷臣竹 1张进 1杨光 1张兰1
作者信息
- 1. 四川省骨科医院麻醉科,四川 成都610041
- 折叠
摘要
Abstract
Objective To evaluate the analgesic effect of continuous femoral nerve block combined with periarticular in-jection of knee joint after knee arthroplasty. Methods 86 patients undergoing unilateral total knee arthroplasty were randomly di-vided into two groups(n = 43):continuous femoral nerve block combined with periarticular injection of knee joint(P group)and continuous femoral nerve block combined with a single sciatic nerve block( S group) . The two groups were implanted with continu-ous femoral nerve catheter and received a single injection of 30ml of 0. 2% ropivacaine preoperatively. In the P group,30 ml of 0. 33% ropivacaine was injected around the knee joint and S group received single classical posterior sciatic nerve block injection of 25ml of 0. 2% ropivacaine intraoperatively. When completed,patient controlled analgesia(PCA)was administered to pump in 0. 2% ropivacaine for 72 h. The pain intensity of the limbs was observed at 1,12,24,48,and 72 h postoperatively,and the VAS score was used to evaluate the rest / motor VAS scores(Passive flexion of 30 °of the knee jiont VAS score)with visual analogue scale( VAS) . The number of analgesic pump presses at each period and the number of people supplementing tramadol after opera-tion were recorded;Postoperative analgesia satisfaction and complications were observed; The range of motion of knee joint was compared between 1 to 3 days and 1 week after operation. Results There were no significant differences of the rest / motor VAS score at 1,12,24,48 and 72 h(P> 0. 05);The number of analgesia pump and the number of people supplementing tramadol were significantly higher in group P than in group S(P<0. 05);The range of motion of knee joint in group P was significantly smaller than that in group S(P<0. 05);The satisfaction of group S was higher than that of group P(P<0. 05). Conclusion Continuous femoral nerve block combined with periarticular injection of knee joint after knee arthroplastyneed more adjuvant anesthetic and may lead to the decreasing of range of motion of knee joint in a short period of time after surgery.关键词
连续股神经阻滞/膝关节周围注射/坐骨神经阻滞/全膝关节置换/术后镇痛Key words
continuous femoral nerve block/periarticular injection of knee joint/sciatic nerve block/total knee arthro-plasty/postoperative analgesia分类
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殷臣竹,张进,杨光,张兰..连续股神经阻滞联合膝关节周围注射在膝关节置换术后镇痛效果观察[J].四川医学,2017,38(2):192-195,4.
