连续股神经阻滞在全膝关节置换术后镇痛及早期康复锻炼中的作用

目的：前瞻性评价连续股神经阻滞在全膝关节置换术后镇痛及早期康复锻炼中的作用。方法：自2008年12月至2009年8月，将进行单侧全膝关节置换术的80例患者进行配对设计随机分组，每组40例。A组采用术后股神经阻滞，B组采用静脉止痛泵镇痛。A组男5例，女35例，平均年龄(65.0±4.2)岁；B组男5例，女35例，平均年龄(64.7±8.5)岁。两组患者术后镇痛持续3 d.记录VAS疼痛评分、睡眠状态、膝关节功能锻练情况和不良反应发生状况。结果：A组患者在术后2、6、24、36、48、56、72 h的VAS评分明显低于B组(P<0.05或P<0.01);A组睡眠状态好于B组。A组患者术后的膝关节主动活动早于B组，B组不良反应发生例数明显大于A组，并且B组止痛药的使用频率高于A组。结论：连续股神经阻滞术后镇痛，效果良好，安全性能好，不良反应发生率低，是全膝关节置换术后理想的镇痛方法也利于患膝关节术后的功能恢复。

Effect of continuous femoral nerve block in analgesia and the early rehabilitation after total knee replacement

Objective: To evaluate the benefit and safety of continuous femoral nerve block in patients undergoing total knee arthroplasty. Methods: From December 2008 to August 2009,80 patients with total knee arthroplasty were randomly divided into two groups,40 patients in each group. In group A the pain-controll was dominanted by continuous femoral nerve block,there were 5 males adn 35 females with an average age of(65.0±4.2)years old;In group B the pump of vein odynolysis was used,there were 5 males and 35 females with an average age of(64.7±8.5)years old. The treatment of relieve pain continued for 3 days. The pain of visual analog scale(VAS),sleep condition,early-stage rehabilitation and adverse effects were recorded. Results: The VAS scores of group A was lower than that of group B at 2,6,24,36,48,56,72 h after operation(P<0.05 or P<0.01);The sleep condition and early-stage rehabilitation of group A were better than that of group B. The complications of group B occurrenced more than group A;The analgetica of group B were used more than that of group A. Conclusion: The continuous femoral nerve block is an effective pain relieve method and is benefical to rehabilitation from total knee arthroplasty early.