术前股神经阻滞对全麻下全膝关节置换术老年患者的超前镇痛效果分析

目的:探讨全麻下全膝关节置换术前股神经阻滞对老年患者超前镇痛的效果。方法:86例接受全麻下全膝关节置换术治疗的老年患者随机分为观察组(n=43)与对照组(n=43),观察组给予术前股神经阻滞+全身麻醉,对照组给予单纯全身麻醉,对比两组患者术后疼痛视觉模拟评分(visual Analogue Scale,VAS)、镇痛药物使用情况及不良反应。结果:术后24 h观察组VAS评分显著低于对照组(P<0.01);观察组术后首次使用镇痛药物时间显著长于对照组(P<0.01),术后48 h内镇痛药物使用次数显著少于对照组(P<0.01),术后48 h镇痛药物使用率显著低于对照组(P<0.05);观察组不良反应发生率为显著低于对照组的48.8%(P<0.01)。结论:术前股神经阻滞用于全麻下老年全膝关节置换术的超前镇痛,能够更加有效的缓解患者围手术期疼痛程度,减少镇痛药物使用量,降低不良反应发生率,值得推广。

Analysis of effect of preoperative femoral nerve block for preemptive anal-gesia in elderly patients undergoing total knee arthroplasty under general anesthesia

Objective:To discuss the Analysis of effect of preoperative femoral nerve block for preemptive analgesia in elderly patients undergoing total knee arthroplasty under general anesthesia.Methods:86 elderly patients undergoing total knee arthroplasty un-der general anesthesia were randomly divided into observation group (n =43 )and control group(n =43 ),the observation group re-ceived preoperative femoral nerve block and general anesthesia,general anesthesia was used in the control group,postoperative pain vis-ual analogue scale(visual analogue scale,VAS),usage of analgesic drug and adverse reactions were compared in the two groups.Re-sults:24 h after operation,visual Analogue Scale(VAS)score in the observation group was significantly lower than that in the control group(P <0.01 ).After operation,the time of the usage of analgesic drugs in the observation group for the first time was longer than that in the control group(P <0.01 ),postoperative within 48h,the frequency of the use of analgesic drugs in the observation group was sig-nificantly less than that in control group(P <0.01 ).48 h after operative,the rate of analgesic drug use was significantly lower than that of the control group (P <0.05).The incidence rate of adverse reactions in the observation group was significantly lower than that in the control group(21 /43)(P <0.01 ).Conclusion:Preoperative femoral nerve block for preemptive analgesia in elderly patients undergo-ing total knee arthroplasty under general anesthesia,can be more effective for relieving the degree of perioperative pain in patients,re-duce the usage of analgesic drug usage,and reduce the incidence of adverse reactions,it is worth to be popularized in clinical treatment.