浅析超声引导下连续股神经阻滞用于全膝关节置换术术后镇痛的效果观察

Brief investigation by observing effect of ultrasound-guided continuous femoral nerve block for postoperative analgesia in total knee replacement

目的探讨全膝关节置换术使用超声引导连续股神经阻滞的镇痛效果。方法 40例单侧全膝关节置换术患者,随机分为A、B组,各20例。A组使用超声引导连续股神经阻滞镇痛,B组使用静脉自控镇痛,全身麻醉进行手术。比较两组的镇痛效果。结果 A组2、4、12、24、48 h视觉模拟评分法(VAS)评分低于B组(P<0.05)。A组2、4、12 h下肢肌力评分低于B组(P<0.05),24、48 h两组下肢肌力评分比较差异无统计学意义(P>0.05)。B组患者术后恶心、呕吐发生率40%高于A组10%(P<0.05)。结论超声引导连续股神经阻滞用于全膝关节置换术术后镇痛优于传统自控镇痛,术后不良反应率低,值得临床推广使用。

Objective To investigate analgesic effect by ultrasound-guided continuous femoral nerveblock in total knee replacement. Methods A total of 40 patients receiving unilateral total knee replacement wererandomly divided into group A and group B, with 20 cases in each group. Group A received ultrasound-guidedcontinuous femoral nerve block for analgesia, and group B received patient-controlled intravenous analgesia.They all received operation under general anesthesia. Analgesic effects were compared between the two groups.Results Group A had all lower visual analog scale (VAS) scores in postoperative 2, 4, 12, 24 and 48 h thangroup B (P<0.05). Group A had lower limb muscle force scores than group B in postoperative 2, 4, 12 h (P<0.05),while their difference in 24 and 48 h had no statistical significance (P>0.05). Incidence of postoperative nauseaand emesis was higher in group B as 40% than 10% in group A (P<0.05). Conclusion Ultrasound-guided continuousfemoral nerve block is better than conventional patient-controlled analgesia for postoperative analgesia in total kneereplacement, along with low incidence of adverse reactions. This method is worth clinical promotion and application.