超声引导股神经阻滞复合舒芬太尼静脉镇痛对老年患者全膝关节置换术后的效果评价

Evaluation on the Post-Operative Effect of Total Knee Arthroplasty in Elderly Patients Using Ultrasound-Guided Femoral Nerve Block Combined with Sufentanil Intravenous Analgesia

目的评价超声引导股神经阻滞复合舒芬太尼静脉镇痛对老年患者全膝关节置换术后的效果。方法选择行全膝关节置换术的老年患者63例,随机分为试验组(自控静脉镇痛+股神经阻滞)和对照组(硬膜外镇痛)。记录两组术后6 h、12 h、24 h的VAS评分和BCS评分,不良反应以及各个时点的HR、MAP。结果试验组术后6 h、12 h、24 h的VAS评分均显著低于对照组,BCS评分均显著高于对照组(P<0.05)。试验组的不良反应发生率为6.06%,显著低于对照组的30.00%(P<0.05)。试验组麻醉后HR和MAP与麻醉前比较差异无统计学意义(P>0.05);对照组麻醉后HR较麻醉前明显升高,MAP明显降低(P<0.05)。结论超声引导股神经阻滞复合舒芬太尼静脉镇痛应用于老年全膝关节置换术患者的术后镇痛效果显著。

Objective To evaluate the post-operative effect of total knee arthroplasty in elderly patients using ultrasound-guided femoral nerve block combined with sufentanil intravenous analgesia. Methods 63 cases of elderly patient with total knee arthroplasty were randomly divided into the experimental group （patient-controlled intravenous analgesia combined with femoral nerve block） and the control group （epidural analgesia）. The scores of VAS and BCS at 6, 12 and 24 hours after surgery, adverse reactions, as well as HR and MAP at different time points were recorded. Results At 6, 12 and 24 hours after surgery, the VAS score of experimental group was significantly lower than that of control group, and the BCS score was significantly higher than that of control group （P 〈0.05）. The incidence of adverse reactions of experimental group was 6.06%, significantly lower than 30.00% of control group （P 〈0.05）. After anesthesia, the HR and MAP of experimental group had no statistical change （P〉0.05）, while in the control group, the HR increased significantly, and the MAP decreased significantly （P 〈0.05）. Conclusions Ultrasound-guided femoral nerve block combined with sufentanil intravenous analgesia applied in elderly patients with total knee arthroplasty has significant post-operative analgesic effect.