超声引导下连续下肢神经阻滞应用于老年患者全膝关节置换术及术后镇痛的效果

Ultrasound-guided continuous lower limb nerve block for total knee arthroplasty in elderly patients and the clinical effect of postoperative analgesia

目的研究并分析超声引导下连续下肢神经阻滞应用于老年患者全膝关节置换术及术后镇痛的临床效果。方法两组患者均行患侧下肢神经阻滞膝关节置换,此外研究组患者在超声引导下行腰丛神经鞘内置管;对照组患者行"鸡尾酒疗法"。结果术后12、24、48 h研究组患者VAS评分均显著低于对照组;研究组CRP为(43.34±9.85)ng/L,显著低于对照组(60.98±12.76)ng/L;研究组IL-6为(201.21±23.11)pg/mL显著低于对照组(280.65±34.52)pg/mL;研究组术后24、36、48 h膝关节主动屈曲度为(36.96±2.1)°、(48.97±2.3)°、(65.38±3.5)°显著大于对照组(30.10±2.0)°、(30.12±1.9)°、(36.86±3.2)°(P <0.05)。结论超声引导下下肢神经阻滞不仅可以满足关节置换术的手术镇痛需求,而且腰丛神经鞘内置管行连续的神经阻滞为术后长期镇痛提供了可能。

Objective To study and analyze ultrasound-guided continuous lower limb nerve block for total knee arthroplasty in elderly patients and the clinical effect of postoperative analgesia.Methods Both groups received knee replacement under lower limb nerve block.Patients in the study group received ultrasound-guided sciatic nerve sheath insertion;whereas those in the control group received“cocktail therapy”.Results 12 h,24 h,and 48 h after the procedure,the VAS scores of the study group were significantly lower than those of the control group.CRP was significantly lower In the study group(43.34±9.85)ng/L than in the control group(60.98±12.76)ng/L;IL-6 was significantly lower in the study group(201.21±23.11)pg/mL than in the control group(280.65±34.52)pg/mL.After the procedure,active knee flexion in study group(36.96±2.1)°,(48.97±2.3)°,and(65.38±3.5)°at 24 h,36 h,and 48 h were significantly higher than those in the control group(30.10±2.0)°,(30.12±1.9)°,and(36.86±3.2)°(P<0.05).Conclusion Ultrasound-guided lower limb nerve block can not only meet the need of surgical analgesia of joint replacement,but also provide the possibility of long-term postoperative analgesia.