超声引导股神经阻滞复合局部麻醉下膝关节置换术的镇痛效果

The analgesic efficacy of knee replacement under ultrasound-guided femoral nerve block combined with local anesthesia

目的探讨超声引导股神经阻滞复合局部麻醉下膝关节置换术的镇痛效果。方法选取2019年1月至2020年6月我院收治的60例行膝关节置换术患者作为研究对象,采用随机数字表法将其均分为对照组与复合组,每组各30例。其中,对照组采用腰硬联合麻醉,复合组实施超声引导下股神经阻滞复合局部麻醉,比较两组患者静息和运动状态下不同时间段的VAS评分、麻醉前后血清指标、不良反应总发生率以及镇痛效果。结果复合组静息、运动状态不同时间段的VAS评分均低于对照组,差异有统计学意义(P<0.05)。麻醉前两组血清指标比较,差异无统计学意义(P>0.05),麻醉后两组各项指标均明显提升,且对照组提升幅度高于复合组,差异有统计学意义(P<0.05)。复合组不良反应总发生率为3.33%,明显低于对照组的20.00%,差异有统计学意义(P<0.05)。复合组总有效率为96.67%,明显高于对照组的80.00%,差异有统计学意义(P<0.05)。结论对行膝关节置换术患者采用股神经阻滞复合局部麻醉,相比于单独使用腰硬联合麻醉,有利于改善血清指标,减少患者不良反应发生状况,提升患者的麻醉效果。

Objective To investigate the analgesic efficacy of knee joint replacement under ultrasound-guided femoral nerve block combined with local anesthesia.Methods A total of 60 patients admitted to our hospital and treated with knee joint replacement from January to December 2019 to June 2020 were selected as the research objects,and they were divided into the control group(n=30)and the combined group(n=30)according to the random number table method.Among them,the control group was treated with combined spinal-epidural anesthesia,while the combined group was treated with ultrasound-guided femoral nerve block combined with local anesthesia.The VAS score at different times in resting and exercise state,serum status before and after anesthesia,total incidences of adverse reactions(ADRs)and analgesic efficacies were compared between the two groups of patients.Results The pain scores of the two groups were compared,and pain scores of the combined group in the rest and exercise states were lower than those of the control group at different times(P<0.05).The serum indexes of the two groups were compared,and there was no statistically significant difference before anesthesia(P>0.05),while all indexes were obviously improved after anesthesia between the two groups,especially the increase of all indexes in the control group were higher than that in the combined group(P<0.05).The total incidences of ADRs between the two groups were compared,and the combined group was 3.33%,which was significantly lower than 20.00%in the control group(P<0.05).The efficacy rate in the combined group was 96.67%,which was significantly higher than 80.00%in the control group(P<0.05).Conclusion Compared with combined spinal-epidural anesthesia alone,femoral nerve block combined with local anesthesia can improve serum indexes,reduce the incidence of ADRs and improve the anesthetic efficacy of patients.