浙江医学2018，Vol.40Issue(6)：603-606,611,5.DOI:10.12056/j.issn.1006-2785.2018.40.6.2017-751
超声引导连续隐神经阻滞在老年全膝关节置换术后镇痛中的应用
Efficacy of ultrasound-guided continuous saphenous nerve block for postoperative analgesia after total knee prosthesis in elderly patients
摘要
Abstract
Objective To evaluate the efficacy of ultrasound-guided continuous saphenous nerve block for postoperative analgesia after total knee prosthesis under general anesthesia in elderly patients.Methods Ninety patients aged 61 ～ 79 years with ASA Ⅰ ～ Ⅲ scheduled to undergo unilateral total knee prosthesis under general anesthesia were randomly divided into three groups with 30 cases each.In group Ⅰ,sufentanil was used for patient controlled intravenous analgesia (PCIA),while in group F and group S,continuous femoral nerve block or saphenous nerve block were used respectively for postoperative analgesia.Visual analogue scale (VAS) pain scores in rest and movement,quadriceps strength levels,comfort levels,the case of analgesic drug addition and occurrence rate of side-effects were recorded at the 2h(T1),6h(T2),12h(T3),24h(T4) and 48h(T5) after surgery.Results The VAS pain scores in rest of the groups F and S were significantly lower than that of the group Ⅰ at time points of T1,T2 and T3 (P＜0.05),while there was no significant difference at T4～ T5 (P ＞0.05).The VAS pain scores in motion of group F and S were significantly lower than that of group Ⅰ at time points T1 ～ T5 (P＜0.05).The quadriceps strength levels in group Ⅰ and group S had no significant difference at T1 ～ T5,while the quadriceps strength levels in group F were significantly lower than those in group Ⅰ and S (P＜0.05).The comfort scores of group S and F were significantly higher than that of group Ⅰ at T1 ～ T5(P＜0.05).The cases of analgesic drug addition in the group of Ⅰ (21,70％) were more than those of the group F (2,6.67％) and S (4,13.33％) (P＜0.05).The rate of nausea,vomiting and drowsiness in group Ⅰ was higher than that in group F and group S (P＜0.05).The rate of other adverse effect had no significant difference in the three groups.Conclusion Continuous saphenous nerve block and continuous femoral nerve block have similar efficacy for postoperative analgesia and low incidence of side-effects in the patients undergoing total knee prosthesis,but the quadriceps muscle strength is less affected in saphenous nerve block.关键词
超声引导/隐神经阻滞/股神经阻滞/术后镇痛/膝关节置换Key words
Ultrasound-guided/Saphenous nerve block/Femoral nerve block/Postoperative analgesia/Knee arthroplasty引用本文复制引用
彭文勇,屠文龙,杜光生,王伟..超声引导连续隐神经阻滞在老年全膝关节置换术后镇痛中的应用[J].浙江医学,2018,40(6):603-606,611,5.基金项目
浙江省临床科研基金项目(2012ZYC-A82) （2012ZYC-A82）
