地佐辛连续股神经阻滞对老年全膝关节置换术后镇痛效果的影响

Effect of Dezocine Continuous Femoral Nerve Block on Postoperative Analgesia in Elderly Patients Undergoing Total Knee Arthroplasty

目的:探讨地佐辛连续股神经阻滞对老年全膝关节置换术后镇痛效果的影响。方法:选取2015年9月-2017年9月间收治的老年全膝关节患者144例,采用随机数字法分为对照组和观察组,每组各72例。对照组患者术后采用常规静脉镇痛泵镇痛,观察组患者采用地佐辛连续股神经组滞镇痛。比较两组患者术后镇痛评级、膝关节活动及不良反应发生率。结果:术后12 h、48 h,观察组患者静息状态VAS评分明显低于对照组(P<0.05);术后3 d、7 d,观察组患者活动后VAS评分明显低于对照组(P<0.05);术后12 h、48 h,观察组患者膝关节活动力度高于对照组(P<0.05),同时观察组患者的四头肌肌力明显低于对照组(P<0.05);术后观察组不良反应发生率明显低于对照组(χ^(2)=3.87,P=0.04)。结论:地佐辛连续股神经阻滞能有效地缓解全膝关节置换术后疼痛,有助于早期膝关节功能的康复训练和术后恢复,且安全性较高,值得在临床推广应用。

Objective: To study the analgesic effect of dezocine continuous femoral nerve block on elderly patients after total knee arthroplasty. Methods: 144 elderly patients with total knee joints admitted to the hospital from September 2015 to September2017 were selected,and they were divided into the control group and the observation group by random number method, with 72 cases in each group. Results: 12 h and 48 h after operation, the VAS score of the resting state of the observation group was significantly lower than that of the control group(P<0.05). 3 d and 7 d after operation, the VAS score of the observation group was significantly lower than that of the control group(P<0.05). 12 h and 48 h after operation, the knee joint of the observation group was more active than the control group(P<0.05), and the quadriceps muscle strength of the observation group was significantly lower than that of the control group(P<0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group(χ2=3.87,P=0.04). Conclusion: Dezocine continuous femoral nerve block can effectively relieve the pain after total knee replacement,help early rehabilitation and postoperative recovery of knee joint function, and has high safety.So it is worthy of clinical use.