两种不同神经阻滞方法对全膝关节置换术后疼痛的影响

Two Different Methods Replacement Affects Nerve Block for Postoperative Pain Following Total Knee

目的:比较两种不同神经阻滞方法对全膝关节置换术后疼痛的影响。方法:将60例采用TKA手术治疗的膝关节炎患者分成观察组和对照组,分别采用连续后路腰丛联合坐骨神经阻滞和采用持续股神经阻滞,比较两种方法镇痛效果。结果:静息时两组6、12、1 d VAS评分均逐渐升高,而3、5 d后VAS评分均逐渐降低,但观察组变化幅度明显高于对照组,两组比较差异均有统计学意义(P<0.05)。活动后1、3、5 d两组VAS评分逐渐降低,但观察组降幅明显大于对照组(P<0.05)。观察组额外使用止痛药次数明显少于对照组,两组比较差异均有统计学意义(P<0.05)。结论:两种神经阻滞方法都能很好的改善TKA术后疼痛,但连续后路腰丛联合坐骨神经阻滞止痛效果更好,额外使用止痛药物次数更少。

Objective：To compare the two methods of different nerve block for pain after total knee arthroplasty.Method：60 patients with TKA surgery of patients with knee arthritis were divided into observation group and control group,respectively adopt continuous posterior lumbar plexus combined sciatic nerve block and adopting continuous femoral nerve block,two methods analgesic effect were compared.Result：Two groups of 6 h,12 h when resting,1 d scores were increased,and the 3 d,5 d after VAS score were gradually decreased,but the change in observation group was obviously higher than that of control group（P〈0.05）.After 1 d,3 d,5 d two groups gradually reduce VAS score,but the decline in observation group was obviously greater than the control group（P〈0.05）.Number of additional use of painkillers observation group was obviously less than control group（P〈0.05）.Conclusion：Two methods of nerve block can be very good improve TKA postoperative pain,but a continuous posterior lumbar plexus combined sciatic nerve block analgesia effect is better,less number of additional use of painkillers.