不同部位注射复合药物对前交叉韧带重建术后疼痛的影响

Different injection location of combined drug for pain control in anterior cruciate ligament reconstruction

目的比较不同部位注射复合镇痛药物对前交叉韧带重建术后疼痛的影响。方法 100例行前交叉韧带重建手术的患者,随机分为四组,每组25例。分别于关节腔内、关节腔周围滑膜组织、大腿根部股神经周围注射复合镇痛药物以及对照组(不注射任何药物)。比较术后6、12、24、48 h的疼痛差异。结果三个复合镇痛药物注射组镇痛作用均明显优于对照组(P<0.01),股神经阻滞镇痛效果明显优于关节腔内注射和关节腔周围注射(P<0.01),关节腔内注射与关节腔周围注射镇痛效果差异无统计学意义(P>0.05)。结论不同部位注射复合药物可产生程度不同镇痛作用,以股神经阻滞镇痛效果最好。

Objective To determine the impact of different injection locations of combined drug on pain control after anterior cruciate ligament reconstruction. Methods We randomly assigned 100 patients into four groups （25 per group） .. intraarticular injection group, peri-articular injection group, femoral nerve block group with injection of combined drug, and placobo group with no injection. We compared the difference in pain relief among these groups at 6, 12, 24 and 48 h after operation. Results Combined drug injection could relief pain more significantly in early period after anterior cruciate ligament reconstruc- tion than in control group （P〈0. 01）. Pain control of femoral nerve block was more effects than in intra-articular and peri-ar- ticular injection groups （P〈0. 01）, and there was no significant difference between intra-articular and peri-articular injection groups （P〉0. 05）. Conclusion Different injection locations of combined drug had different effects on pain control after anterior cruciate ligament reconstruction, and the femoral nerve block obtained the most satisfactory effect of all four groups.