不同镇痛方法对全膝关节置换术术后疼痛和功能恢复的影响

Effects of different methods of analgesia on postoperative pain and functional recovery after total knee arthroplasty

目的探讨不同镇痛方法对全膝关节置换术(TKA)术后疼痛和功能恢复的影响。方法选自该院2014年6月‐2015年6月收治的行TKA患者82例,依据随机数字表法随机分为A组41例和B组41例。A组采用连续股神经阻滞,B组采用静脉镇痛。比较两组术前、术后3 d及术后7 d视觉模拟疼痛量表(VAS)评分、肌力评级及膝关节功能评分(HSS)。结果两组VAS评分术前比较差异无统计学意义(P>0.05);两组VAS评分术后3 d、术后7 d明显降低(P<0.05);A组VAS评分术后3 d、术后7 d低于B组(P<0.05);两组术前、术后3 d、术后7 d肌力评级比较差异无统计学意义(P>0.05);两组膝关节HSS评分术前比较差异无统计学意义(P>0.05);两组膝关节HSS评分术后3 d、术后7 d明显增加(P<0.05);A组膝关节HSS评分术后3 d、术后7 d高于B组(P<0.05)。结论连续股神经阻滞对TKA术后疼痛和功能恢复明显优于静脉镇痛。

【Objective】To investigate the impact of different methods of analgesia on postoperative pain and functional recovery after total knee arthroplasty(TKA).【Methods】Eighty-two TKA patients treated in our hospital from June 2014 to June 2015 were selected, and were randomly divided into group A(41 cases) and group B(41 cases). Group A was treated with continuous femoral nerve block and group B with intravenous analgesia. Visual Analogue Scale(VAS) score, muscle strength rating and Hospital for Special Surgery(HSS) knee score were compared between the two groups before surgery and on the 3rd, 7th day after surgery.【Results】There was no significant difference in VAS score between two groups before surgery(P >0.05); VAS scores of two groups on the 3rd, 7th day after surgery were signifi cantly decreased(P <0.05); VAS scores of group A on the 3rd, 7th day after surgery were signifi cantly lower than those of group B(P <0.05); muscle strength rating before surgery and on the 3rd, 7th day after surgery was not signifi cantly different between the two groups(P >0.05); no signifi cant difference in HSS score between the two groups before surgery(P >0.05); HSS scores of two groups on the 3rd, 7th day after surgery were signifi cantly increased(P <0.05); HSS scores of group A on the 3rd, 7th day after surgery were higher than those of group B(P <0.05).【Conclusion】Continuous femoral nerve block was better than intravenous analgesia for postoperative pain and functional recovery of TKA.