超声引导下收肌管阻滞在胫骨骨折中的镇痛效果探讨

Discussion on the Analgesic Effect of Ultrasound-guided Adductor Canalblockade in Tibial Fracture

目的 探讨超声引导下收肌管阻滞在胫骨骨折患者术后镇痛中运用的效果。方法 方便选取2020年3月—2022年12月南京市六合区人民医院收治的110例胫骨骨折患者为研究对象,根据不同麻醉方案分为对照组(n=55,予常规自控镇痛)与观察组(n=55,予超声引导下收肌管阻滞),对比两组患者术后疼痛程度、术后镇痛药物使用情况及不良反应。结果 观察组术后4 h、8 h、12 h、24 h、48 h的静息疼痛评分分别为(3.24±1.24)分、(2.97±1.04)分、(2.80±1.02)分、(2.48±0.84)分、(2.27±0.76)分,低于对照组的(3.95±1.47)分、(3.74±1.22)分、(3.57±1.17)分、(3.24±1.06)分和(2.95±0.94)分,差异有统计学意义(t=2.738、3.562、3.679、4.167、4.172,P均<0.05)。观察组各时间点屈膝疼痛评分均低于对照组,差异有统计学意义(P均<0.05)。观察组曲马多用量少于对照组,不良反应发生率低于对照组,差异有统计学意义(P均<0.05)。结论 胫骨骨折患者术后镇痛中应用超声引导下收肌管阻滞,可减轻术后疼痛并降低麻醉药物使用剂量,且不良反应少。

Objective To explore the effect of ultrasound-guided adductor-canalblockade in postoperative analgesia of tibial fracture patients.Methods A total of 110 patients with tibial fracture admitted to Liuhe District People's Hospital of Nanjing from March 2020 to December 2022 were conveniently selected as the research objects.According to different anesthesia schemes,they were divided into control group(n=55,routine patient-controlled analgesia)and observation group(n=55,ultrasound-guided adductor-canalblockade).The degree of postoperative pain,the use of postoperative analgesic drugs and adverse reactions were compared between the two groups.Results The resting pain scores of the observation group at 4 h,8 h,12 h,24 h and 48 h after operation were(3.24±1.24)points,(2.97±1.04)points,(2.80±1.02)points,(2.48±0.84)points and(2.27±0.76)points,respectively,which were lower than those of the control group(3.95±1.47)points,(3.74±1.22)points,(3.57±1.17)points,(3.24±1.06)points and(2.95±0.94)points,the differences were statistically significant(t=2.738,3.562,3.679,4.167,4.172,all P<0.05).The knee pain score of the observation group were lower than those of the control group at each time point,and the differences were statistically significant(all P<0.05).The dosage of tramadol in the observation group was less than that in the control group,and the incidence of adverse reaction was lower than that in the control group,the differences were statistically significant(both P<0.05).Conclusion The application of ultrasound-guided adductor-canalblockade in postoperative analgesia of patients with tibial fracture can reduce postoperative pain and reduce the dosage of anesthetic drugs,with fewer adverse reactions.