超声引导下连续股神经阻滞在老年患者膝关节置换术术后疼痛的应用

Application of continuous femoral nerve block guided by ultrasound in postoperative pain of elderly patients undergoing knee replacement

目的研究超声引导下连续股神经阻滞在老年患者膝关节置换术术后疼痛的应用效果。方法选取2015年5月~2016年6月在我院接受治疗的老年膝关节置换术患者70例作为研究对象,按照随机数字法分组的原则将患者分为超声引导下连续股神经(CFNB)组和老年患者静脉自控镇痛(PCIA)组,每组各35例,比较两组VAS评分,使用PCA次数及帕瑞昔布钠的总量,以及术后不良反应发生情况。结果观察组在术后6、12、24及48h的VAS评分均要显著低于对照组,差异有统计学意义(P<0.05)。观察组患者帕瑞昔布钠使用总量和PCA次数均显著少于对照组,差异有统计学意义(P<0.05)。观察组术后不良反应发生率为5.7%,显著少于对照组的31.4%,差异有统计学意义(P<0.05)。结论对老年膝关节置换术患者实施超声引导下的CFNB,具有比较明显的镇痛效果,其应用价值要明显高于PCIA组,且不良反应率较低,值得推广应用。

Objective To study the application effect of continuous femoral nerve block guided by uhrasound in postoperative pain of elderly patients undergoing knee replac, ement. Methods 70 cases of ehterly patients undergoing knee replacement cured in our hospital from May 2015 to June 2016 were selected as the study objects. According to digital number,they were randomly divided into continuous femoral nerve block guided by ultrasound （CFNB） group and patient controlled intravenous analgesia （PCIA） group,with 35 cases in each.VAS scores,total number of PCA,the use of parecoxib sodium and incidence of adverse reactions after operation of the two groups were compared. Results VAS scores of 48,12,24 and 6h after operation were all significantly lower than those of control group,and the differences were statistically significant （P 〈 0.05）.The use of parecoxib sodium and total number of PCA were significantly less than those of control group,and the differences were statistically significant （P 〈 0.05）. Incidence of adverse reactions after operation of observation group was 5.7%,which was significantly lower than that of control group with 31.4%,and the difference was statistically significant （P 〈 0.05）. Conclusion CFN B guided by ultrasound in elderly patients undergoing knee replacement has a more obvious analgesic effect.Its application value is significantly higher than that of PCIA group.Its adverse reaction rate is low.h is worth popularizing and applying.