超声引导下IPACK联合收肌管阻滞在膝关节骨性关节炎的慢性痛及膝关节手术后镇痛中的应用

Application of Ultrasound-guided IPACK Combined with Adductor Tube Block in Chronic Pain of Knee Osteoarthritis and Postoperative Analgesia of Knee Joint

目的分析超声引导下腘动脉与膝关节囊后间隙(infiltration between the popliteal artery and capsule of the knee,IPACK)联合收肌管阻滞(adductor canal block,ACB)在膝关节骨性关节炎(knee osteoarthritis,KOA)的慢性痛及膝关节手术后镇痛中的应用效果。方法选取南京市六合区中医院于2021年7月—2022年9月收治的60例KOA患者作为研究对象,根据不同治疗方法将其分为对照组(n=30)与观察组(n=30)。对照组行超声引导下股神经阻滞(femoral nerve block,FNB),观察组行超声引导下IPACK联合ACB。以两组术后镇痛效果、膝关节活动度以及术后并发症等指标为对比项目。结果术后两组患者静态VAS评分与动态VAS评分比较,差异无统计学意义(P>0.05);观察组术后各个时间点膝关节活动度改善情况均优于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率6.66%低于对照组的30.00%,差异有统计学意义(χ^(2)=5.455,P<0.05)。结论超声引导下IPACK联合ACB麻醉,可减轻KOA患者术后疼痛程度,改善膝关节活动度,降低术后并发症。

Objective To analyze the application effect of ultrasound-guided infiltration between the popliteal artery and capsule of the knee(IPACK)combined with adductor canal block(ACB)in chronic pain of knee osteoarthritis(KOA)and postoperative analgesia of knee joint.Methods 60 patients with KOA admitted to Nanjing Liuhe District Hospital of Traditional Chinese Medicine from July 2021 to September 2022 were selected as the study subjects.They were divided into control group(n=30)and observation group(n=30)according to different treatment methods.The control group received ultrasound-guided femoral nerve block(FNB),and the observation group received ultrasoundguided IPACK combined with ACB.The postoperative analgesia effect,knee joint range of motion and postoperative complications of the two groups were compared.Results There was no statistically significant difference between static VAS score and dynamic VAS score between the two groups(P>0.05);the improvement of knee joint range of motion in the observation group was better than that in the control group at all time points after operation,the difference was statistically significant(P<0.05);the incidence of complications in the observation group was 6.66%,lower than that in the control group 30.00%,the difference was statistically significant(χ^(2)=5.455,P<0.05).Conclusion Ultrasoundguided IPACK combined with ACB anesthesia can reduce the postoperative pain degree of KOA patients,improve the knee joint queen and reduce postoperative complications.