局解手术学杂志2024，Vol.33Issue(6)：509-513,5.DOI:10.11659/jjssx.07E023083
隐神经联合膝关节囊后阻滞对全膝关节置换术后应激反应、镇痛效应及关节功能恢复的影响
Effects of saphenous nerve combined with posterior capsular block of knee joint on stress response,analgesic effect and joint function recovery after total knee arthroplasty
摘要
Abstract
Objective To investigate the effects of saphenous nerve combined with posterior capsular block of knee joint on stress response,analgesic effect and joint function recovery of patients after total knee arthroplasty.Methods A total of 98 patients who received total knee arthroplasty in our hospital from January 2021 to January 2022 were selected and divided into the observation group(received saphenous nerve combined with posterior capsular block of knee joint)and the control group(received saphenous nerve block)by random number table,with 49 patients in each group.The visual analogue scale(VAS)score of resting and dynamic pain 6 hours,12 hours and 24 hours after surgery of patients in the two groups were compared.The range of knee joint motion before surgery,3 days,5 days and 7 days after surgery of patients in the two groups were compared.The stress indexes[cortisol(Cor),adrenocorticotropic hormone(ACTH)],and pain mediator indexs[calcitonin gene-related peptide(CGRP),beta-endorphins(β-EP),6-keto prostaglandin E1α(6-Keto-pGE1α),substance P(SP)]before surgery,4 hours,12 hours,24 hours,and 48 hours after surgery of patients in the two groups were compared.The occurrence of adverse reactions during treatment of patients in the two groups were recorded.Results There were statistically significant differences in the resting and dynamic VAS scores at different time points of patients in the two groups in terms of time factors,inter-group factors and interaction factors(P<0.05).There were statistically significant differences in the range of knee joint motion at different time points of patients in the two groups in terms of time factors,inter-group factors and interaction factors(P<0.05).There were statistically significant differences in the Cor and ACTH contents at different time points of patients in the two groups in terms of time factors,inter-group factors and interaction factors(P<0.05).There were statistically significant differences in the contents of β-EP,SP,CGRP and 6-keto-PGE1α at different time points of patients in the two groups in terms of time factors,inter-group factors and interaction factors(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Saphenous nerve combined with posterior capsular block of knee joint for total knee arthroplasty can reduce patients' stress response,enhance postoperative analgesic effect,and improve the early motor function,with high safety.关键词
隐神经阻滞/膝关节囊后阻滞/全膝关节置换术/应激反应/疼痛介质Key words
saphenous nerve block/posterior capsular block of knee joint/total knee arthroplasty/stress response/pain mediator分类
医药卫生引用本文复制引用
冯腾尘,王佳奕,姚杰,赵继波,孙晓佳,李福龙..隐神经联合膝关节囊后阻滞对全膝关节置换术后应激反应、镇痛效应及关节功能恢复的影响[J].局解手术学杂志,2024,33(6):509-513,5.基金项目
2022年度河北省科学研究课题计划项目(20220620) （20220620）
张家口市科技技术局项目(2121134D) （2121134D）
