单次与持续股神经阻滞联合鸡尾酒疗法在全膝关节置换术后的效果分析

Effect analysis of single and continuous femoral nerve block combined with cocktail therapy after total kNee replacement

目的:对比探究对全膝关节置换患者运用单次又或是持续股神经阻滞联合“鸡尾酒疗法”两种治疗方法分别所取得的成效。方法:选用2021年5月到9月间,在北京大学第三医院骨科进行治疗的100位全膝关节置换患者作为研究对象,并采用随机分配法将其划分成两个小组,每个小组各50位,对于观察组完成手术以后采用单次股神神经阻滞联合鸡尾酒疗法来进行术后镇痛,而对照组所采用的就是持续股神经阻滞联合鸡尾酒疗法,然后对比两个小组患者手术完成以后,静息情况下和功能锻炼以后所得出的视觉模拟评分法(VAS)评分;同时在对比分析两个小组手术之后患者的睡眠时长、追加止痛药、出现的并发症情况还有所存有的不良反应发生率。结果:术后24h、48h静息状态下及功能锻炼后患者VAS评分观察组高于对照组(P<0.05);术日及术后第2日夜间睡眠时长观察组高于对照组(P<0.05);术后并发症下肢肌间静脉血栓、尿储留、便秘发生率观察组低于对照组(P<0.05);术后不良反应发生率观察组低于对照组(P<0.05)。结论:单次股神经组织联合疗法虽然在术后镇痛效果上无优势,但结合术后康复,预防并发症,患者舒适度等方面有明显优势。

To compare the effect of single femoral nerve block combined with"cocktail therapy"and continuous femoral nerve block combined with"cocktail therapy"in patients with total kNee replacement.Methods:100 patients with total kNee arthroplasty admitted to the Department of Orthopedics of Peking University Third Hospital from May 2021 to September 2021 were randomly divided into two groups.The observation group(n=50)was treated with single femoral nerve block(FNB)combined with cocktail for postoperative analgesia,and the control group(n=50)was treated with continuous femoral nerve block(FNB)combined with cocktail for postoperative analgesia,The visual analog scale(VAS)scores were compared between the two groups in resting state and after functional exercise;The duration of sleep,complications,additional analgesic drugs and the incidence of adverse reactions were compared.Results:The VAS scores of patients in the observation group were higher than those in the control group at rest 24 hours and 48 hours after operation and after functional exercise(P<0.05);The duration of night sleep on the operation day and the second day after operation in the observation group was higher than that in the control group(P<0.05);The incidence of postoperative complications such as lower limb intermuscular vein thrombosis,urinary retention and constipation in the observation group was lower than that in the control group(P<0.05);The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:Although single femoral nerve tissue combined therapy has no advantage in postoperative analgesia,it has obvious advantages in combination with postoperative rehabilitation,prevention of complications,patient comfort,etc.