两种镇痛方法在髋关节置换术后效果的比较

Efficacy of different analgesia for postoperative pain control after hip arthroplasty

目的比较股神经-连续股外侧皮神经阻滞镇痛与静脉镇痛在髋关节置换术后镇痛的临床效果。方法选择择期行单侧髋关节置换手术患者60例,随机分为2组,静脉镇痛组30例(A组:舒芬太尼3μg/kg),股神经-连续股外侧皮神经阻滞镇痛组30例(B组:0.3%罗哌卡因)。记录术后48 h内静息时的疼痛视觉模拟(VAS)评分、术后不良反应发生率及患者满意度。结果股神经-连续股外侧皮神经阻滞镇痛组VAS评分显著低于静脉镇痛组,差异有统计学意义(P<0.05);B组恶心、呕吐等不良反应发生率明显减少,患者术后镇痛满意度优于A组。结论股神经-连续股外侧皮神经阻滞用于髋关节置换术后的镇痛效果优于静脉镇痛,术后不良反应发生率低,患者满意度高。

Objective To compare the use of femoral nerve （FN） block with continuous lateral femoral cutaneous nerve （CLF- CN） block with patient controlled intravenous analgesia （PCIA） for postoperative pain - management after hip arthroplasty. Methods Da- ta was recorded from 60 patients undergoing hip arthroplasty, the patients were randomly divided into two groups PCIA （group A： sufentanil 3 μg/kg）, nerve block analgesia （group B： 0.3% ropivacaine）. The VAS scores and adverse effects and patients＇satisfaction were recorded at 4,8,22,24 and 48h after surgery. Results The VAS scores were significantly lower in patients receiving the FN - CLFCN blocks than that in patients receiving PICA （P 〈 0.05 ）, and had less adverse effects and the patients satisfaction were higher. Conclusion Femoral nerve block and continuous lateral femoral cutaneous nerve block for postoperative pain control after hip arthroplasty has an advantage than intravenous analgesia.