单次与连续收肌管阻滞对膝关节手术患者术后镇痛效果及下肢肌力的影响

Effect of single and continuous adductor duct block on postoperative analgesia and lower limb muscle strength in patients undergoing knee surgery

目的:比较对接受膝关节手术后的患者进行单次与连续收肌管阻滞(ACB)对其术后镇痛效果及下肢肌力的影响。方法:选择近年来在广州医科大学附属市八医院进行膝关节手术的80例患者作为研究对象,随机将其分为对照组与观察组。对两组患者均进行膝关节手术,术后对观察组患者进行单次ACB,对对照组患者进行连续ACB,然后比较两组患者术后下肢肌力的分级、关节活动度(ROM)评分、视觉模拟评分法(VAS)的评分、不良事件的发生率、自控镇痛泵(PCA)的按压次数及住院的时间。结果:术后24 h及48 h,观察组患者下肢肌力的分级均高于对照组患者,P<0.05。两组患者术后48 h的ROM评分、术后48 h静息状态下与动态下的VAS评分、术后不良事件的发生率、术后第1天和第2天PCA泵的按压次数及术后住院的时间相比,P>0.05。结论:对接受膝关节手术后的患者进行单次与连续ACB均可取得良好的镇痛效果,但对其进行单次ACB有利于其术后下肢肌力的恢复。

Objective:To compare the effects of single and continuous adductor duct block(ACB)on postoperative analgesia and lower limb muscle strength in patients undergoing knee surgery.Methods:A total of 80 patients who underwent knee surgery in the Eighth Affiliated Hospital of Guangzhou Medical University in recent years were selected as the research objects,and randomly divided into control group and observation group.Knee surgery was performed on both groups.Single ACB was performed on the observation group and continuous ACB was performed on the control group.Then the grading of lower limb muscle strength,range of motion(ROM)score,visual analogue scale(VAS)score,incidence of adverse events,compressions of PCA pump and hospitalization time were compared between the two groups.Results:24 h and 48 h after surgery,lower limb muscle strength grading in observation group was higher than that in control group,P<0.05.Compared with the ROM score 48 h after surgery,VAS score 48 h after surgery in resting state versus dynamic state,the incidence of postoperative adverse events,the number of pressing of PCA pump on the first and second day after surgery and the length of postoperative hospitalization in 2 groups,P>0.05.Conclusion:Single and continuous ACB can achieve good analgesic effect in patients after knee surgery,but singl e ACB is beneficial to the recovery of lower limb muscle streng th after surgery.