超声联合神经刺激器引导下股神经阻滞应用于全膝关节置换术的临床研究

Clinical Study on the Effect of Ultrasound Combined with Nerve Stimulator Guided Femoral Nerve Block in Total Knee Arthroplasty

目的:分析研究对全膝关节置换术患者采用超声联合神经刺激器引导下股神经阻滞的临床作用。方法:选取2018年3月至2019年8月期间开封市中心医院收治的全膝关节置换术患者100例作为研究对象,采用随机数字表法将其平均分为两组,分别为对照组(50例)与观察组(50例)。对照组施以神经刺激器引导下连续股神经阻滞镇痛,观察组施以超声联合神经刺激器引导下股神经阻滞镇痛,对两组患者的首次下床活动时间、起效时间及术后静止状态下6 h、12 h、24 h、48 h与术后运动状态下24 h、48 h、72 h的视觉模拟评分法(VAS)评分情况、不良反应发生情况进行比较。结果:术后静止状态下6 h与48 h,两组患者的VAS评分比较,差异无统计学意义(P>0.05);术后静止状态下12 h、24 h及术后运动状态下24 h、48 h、72 h,观察组患者的VAS评分明显较对照组低,并且观察组的首次下床活动时间、起效时间明显较对照组短,不良反应总发生率明显低于对照组,两组间数据比较,差异均具有统计学意义(P<0.05)。结论:超声联合神经刺激器引导下股神经阻滞应用于全膝关节置换术中具有良好的镇痛效果。

Objective To analyze and study the clinical effect of femoral nerve block guided by ultrasound and nerve stimulator in patients undergoing total knee arthroplasty.Methods 100 patients with total knee arthroplasty treated in Kaifeng Central Hospital from March 2018 to August 2019 were selected as the research objects,and they were divided into two groups by random number table method,the control group with 50 cases and the observation group with 50 cases,The control group was given continuous femoral nerve block analgesia under the guidance of nerve stimulator,and the observation group was given femoral nerve block analgesia under the guidance of ultrasound combined with nerve stimulator.The time of first ambulation,onset time,visual analogue scale(VAS)scores at 6 h,12 h,24 h,48 h in the postoperative static state,VAS scores at 24 h,48 h,72 h in the postoperative exercise state,and the occurrence of adverse reactions were compared between the two groups.Results There was no significant difference in VAS scores between the two groups at 6 h and 48 h in static state after operation(P>0.05);The VAS score of patients in the observation group was significantly lower than that in the control group at 12 h and 24 h in static state after operation and at 24 h,48 h and 72 h in exercise state after operation.The first activity time and onset time of the observation group were significantly shorter than those in the control group,and the incidence of adverse reactions was significantly lower than that in the control group.The differences between the two groups were statistically significant(P<0.05).Conclusion Ultrasound combined with femoral nerve block guided by nerve stimulator has a good analgesic effect in total knee arthroplasty.