IPACK阻滞与LIA在膝关节矫形术的应用效果比较

Comparison of the Application of IPACK Block and LIA in Knee Arthroplasty

目的:比较腘动脉与膝关节后囊间隙(IPACK)阻滞与关节周围局部浸润镇痛(LIA)在膝关节矫形术后镇痛中的效果。方法:招募60例膝关节矫形术患者,随机分为IPACK阻滞组(I组)和LIA组(L组)。I组行IPACK阻滞,L组行LIA。记录疼痛评分、满意度评分、主动屈膝最大角度、步行距离、镇痛补救率和不良事件发生情况。结果:与L组比较,8h(T2)时点I组静态疼痛评分降低,差异有统计学意义(Z=-2.171,P<0.05);与L组比较,T2,24h(T3)时点I组动态疼痛评分降低,差异有统计学意义(Z=-1.277、-2.841,P<0.05);与L组比较,I组羟考酮应用率降低,差异有统计学意义(χ^(2)=6.667,P<0.05);与L组比较,I组术后2~3d患者主动屈膝最大角度增加,差异有统计学意义(Z=-2.088、-2.426,P<0.05)。结论:IPACK阻滞较LIA更适合于膝关节矫形术后镇痛。

Objective:To compare the analgesic effect of IPACK and LIA for knee arthroplasty.Methods:60 patients scheduled for knee arthroplasty were randomly divided into two groups:Group I and Group L.IPACK was performed in Group I,and LIA was performed in Group L.Pain score,patient satisfaction,the maximum range of knee motion,the number of ambulatory steps,analgesic remedy and adverse events were recorded.Results:Through comparing with Group L,static pain score of Group I at 8 h(T2)decreased,with statistically significant difference(Z=-2.171,P<0.05).Through comparing with Group L,dynamic pain score of I group at T2 and 24 h(T3)decreased,with statisticall significant difference(Z=-1.277,-2.841;P<0.05).Through comparing with Group L,Oxycodone of Group I decreased significantly,with statistically significant difference(χ^(2)=6.667,P<0.05).Through comparing with Group L,the maximum range of knee motion 2~3 days after operation was increased in Group I,with statistically significant difference(Z=-2.088,-2.426;P<0.05).Conclusion:IPACK block might be more suitable for postoperative analgesia than LIA for knee arthroplasty.