超声引导下髂筋膜阻滞与股神经阻滞治疗全膝关节置换术后镇痛效果对比研究

Comparative Study on the Analgesic Effect of Ultrasound-Guided Iliofascial Block and Femoral Nerve Block in Postoperative Pain Management of Total Knee Arthroplasty

目的分析全膝关节置换术患者利用超声引导下髂筋膜阻滞以及股神经阻滞的镇痛效果。方法选择河南大学淮河医院于2021年6月至2023年6月期间收治的82例全膝关节置换术患者,依据随机数字表法将其分为对照组(超声引导股神经阻滞)和试验组(超声引导髂筋膜阻滞),各41例。对比两组患者术后静息状态时镇痛效果、术后活动状态时镇痛效果、术后患肢肌力状态、术后膝关节功能。结果试验组术后静息状态下2 h、6 h、12 h、24 h疼痛程度均低于对照组,差异具有统计学意义(P<0.05)。试验组术后活动状态下2 h、6 h、12 h、24 h、48 h疼痛程度均低于对照组,差异具有统计学意义(P<0.05)。试验组术后2 h、6 h的肌力状态优于对照组,差异具有统计学意义(P<0.05)。试验组膝关节功能优于对照组,差异具有统计学意义(P<0.05)。结论行全膝关节置换术患者使用超声引导髂筋膜阻滞以及股神经阻滞对术后疼痛均能起到一定效果,其中超声引导髂筋膜阻滞镇痛效果更佳,同时能够促进术后肌力恢复,改善肌力状态,值得应用。

Objective To analyze the analgesic effect of ultrasound-guided iliofascial block and femoral nerve block in patients undergoing total knee arthroplasty.Methods 82 patients who underwent total knee arthroplasty in Huaihe Hospital of Henan University from June 2021 to June 2023 were selected.According to the random number table method,they were divided into the control group(ultrasound-guided femoral nerve block)and the experimental group(ultrasound-guided fascia iliac block),each with 41 cases.The postoperative analgesic effect in the resting state,the postoperative analgesic effect in the active state,the postoperative limb muscle strength state,and the postoperative knee joint function of the two groups were compared.Results The pain levels of the experimental group at 2 h,6 h,12 h,and 24 h after surgery in the resting state were all lower than those of the control group,and the difference was statistically significant(P<0.05).The pain levels of the experimental group at 2 h,6 h,12 h,24 h,and 48 h after surgery in the active state were all lower than those of the control group,and the difference was statistically significant(P<0.05).The muscle strength state of the experimental group at 2 h and 6 h after surgery was better than that of the control group,and the difference was statistically significant(P<0.05).The knee joint function of the experimental group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Both ultrasoundguided iliofascial block and femoral nerve block can have a certain effect on postoperative pain in patients undergoing total knee arthroplasty.Among them,the analgesic effect of ultrasound-guided iliofascial block is better,and it can also promote the recovery of postoperative muscle strength and improve the muscle strength state,which is worth applying.