| TKA术后连续股神经阻滞早期镇痛疗效 |
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| 作者姓名： | 庞佳宁 刘劲松 李溪 王莉竹 张锡华 |
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| 作者单位： | 昆明医科大学第一附属医院骨科 |
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| 基金项目： | 基金: 云南省科技厅应用基础研究联合专项基金资助项目(2013FB144); |
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| 摘 要： | 目的 比较全膝关节置换(TKA)术后连续股神经阻滞镇痛(CFNB)与静脉自控镇痛(PCIA)对全膝关节置换术患者术后早期镇痛的效果及功能恢复的影响.方法 回顾分析昆明医科大学第一附属医院2014年1月至2015年1月ASA分级Ⅰ~Ⅱ级行单侧全膝关节置换手术患者60例.根据术后采用的镇痛方式的不同随机分为CFNB组(治疗组),PCIA组(对照组),其中CFNB组30例,PCIA组30例.观察指标包括:术后患侧膝关节静息痛及运动痛VAS评分;术后患侧膝关节活动度(ROM值)及患肢股四头肌肌力;术后7 d内不良反应发生率;术前与术后的3个月HSS评分;术后出院时间.结果 术后CFNB组的静息痛及活动痛疼痛程度平均小于PCIA组;术后1、2、3、5、7 d,CFNB组患侧膝关节活动度(ROM值)及患肢股四头肌肌力明显大于PCIA组;术后7 d内不良反应的比率,PCIA组明显大于CFNB组;术后3个月HSS评分,CFNB组大于PCIA组;术后出院时间,CFNB组明显小于PCIA组,差异均有统计学意义(P<0.05).结论 相比于PCIA镇痛,术后CFNB镇痛临床效果比较明显,可以减轻TKA术后早期膝关节疼痛,增加关节运动活动度,明显缩短住院时间,促进关节锻炼利于功能康复,并且不增加恶心呕吐等不良反应的发生率等优点.
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| 关 键 词： | 股神经阻滞镇痛 静脉自控镇痛 静息痛 运动痛 膝关节活动度 |
| 收稿时间： | 2016-06-21 |
Early Analgesic Effect of Continuous Femoral Nerve Block for Total Knee Arthroplasty |
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| Abstract: | Objective To compare the early analgesic effects of continuous femoral nerve block analgesia(CFNB) and patient controlled intravenous analgesia(PCIA) and their effects on functional recovery after total knee arthroplasty. Methods Retrospective analysis was conducted on 60 ASA I and ASA II patients with unilateral total knee arthroplasty in our hospital from January 2014 to January 2015. The patients were divided into two groups,CFBN group(treatment group) and PCIA group(control group),with 30 patients in each group. VAS scores of postoperative ipsilateral knee resting and movement pain, range of postoperative knee joint motion(ROM),muscle strength of femoral quadriceps,incidence rates of adverse reaction within 7 days after operation,HSS score3 months before and after the operation,and discharge time were observed. Results Postoperative VIS score in CFNB group was lower than that in PCIA group.ROM and muscle strength of femoral quadriceps in CFBN group were better than those in PCIA group on day 1, 2, 3, 5, and 7 after the operation. Postoperative adverse reaction rate within 7 days in PCIA group was significantly higher than that in CFNB group. HSS score three months after the operation in CFNB group was higher than that in PCIA group. Discharge time of CFNB group was significantly earlier than that of PCIA group(P<0.05). Conclusion Compared with PCIA analgesia,CFNBanalgesia shows better analgesic effect. It can alleviate early knee joint pain after TKA, increase joint motion,significantly shorten the hospitalization time, promote joint exercises which are effective in functional rehabilitation, and decrease the incidence of adverse reactions like nausea and vomiting. |
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