摘要
目的探讨超声引导下连续隐神经阻滞用于老年患者全身麻醉下单侧全膝关节置换术超前镇痛的效果。方法选择2020年6—10月济宁医学院附属医院行单侧全膝关节置换术(TKA)治疗的120例老年患者为研究对象,按随机数字表法分为A组(隐神经阻滞组+全身麻醉)、B组(股神经阻滞组+全身麻醉)和C组(单纯全身麻醉组),每组40例。比较三组术后不同时间点视觉模拟量表(VAS)评分、膝关节活动度、RS躁动量表和Ramsay镇静量表评分、术后恢复及镇痛情况。结果A、B组术后6、12、24、48 h VAS静态评分和动态评分比较差异无统计学意义(P>0.05)。A组术后6、12、24、48 h膝关节活动度大于B组和C组[(74.8±8.1)°比(68.4±8.2)°和(63.2±7.0)°、(77.4±10.9)°比(73.0±10.0)°和(68.6±8.3)°、(82.6±10.4)°比(77.4±9.6)°和(73.2±8.3)°、(91.8±6.1)°比(86.8±6.6)°和(82.8±5.3)°],差异有统计学意义(P<0.05)。A、B组术后6、12、24、48 h RS躁动量表评分和Ramsay镇静量表评分比较差异无统计学意义(P>0.05)。A组首次下床时间短于B组[(20.9±3.0)h比(27.4±3.5)h],行走距离长于B组[(7.1±1.6)m比(5.2±1.3)m],差异有统计学意义(P<0.05)。结论超声引导下连续隐神经阻滞用于老年患者全身麻醉单侧TAK术后镇痛效果良好,可促进定向力及膝关节活动恢复。
Objective To investigate the effect of ultrasound-guided continuous saphenous nerve block on preemptive analgesia in elderly patients undergoing unilateral total knee arthroplasty(TKA)under general anesthesia.Methods A total of 120 elderly patients who received unilateral TKA in the Affiliated Hospital of Jining Medical College from June 2020 to October 2020 were enrolled and they were divided into group A(saphenous nerve block+general anesthesia),group B(femoral nerve block+general anesthesia)and group C(simple general anesthesia)by random numbering method,with 40 cases in each group.The visual analogue pain(VAS)scores,knee range of motion,RS agitation scores and Ramsay sedation scores at different time points after surgery and postoperative recovery and analgesia were compared among the three groups.Results The static state and dynamic state VAS scores in the group A and group B at 6,12,24,48 h after the surgery had no significant differences(P>0.05).The knee range of motion in the group A at 6,12,24,48 h after the surgery were higher than that in group B and group C:(74.8±8.1)°vs.(68.4±8.2)°and(63.2±7.0)°,(77.4±10.9)°vs.(73.0±10.0)°and(68.6±8.3)°,(82.6±10.4)°vs.(77.4±9.6)°and(73.2±8.3)°,(91.8±6.1)°vs.(86.8±6.6)°and(82.8±5.3)°,the differences were statistically significant(P<0.05).The RS agitation scores and Ramsay sedation scores in the group A and group B had no significant differences(P>0.05).The first time to the ground in the group A was shorter than that in the group B:(20.9±3.0)h vs.(27.4±3.5)h;the walking distance in the group A was longer than that in the group B:(7.1±1.6)m vs.(5.2±1.3)m,the differences were statistically significant(P<0.05).Conclusions Ultrasound-guided continuous saphenous nerve block has a good postoperative analgesic effect in elderly patients with unilateral TAK under general anesthesia.It can promote the recovery of directional force and knee range of motion in patient.
作者
张成栋
刘群
江海滨
李彦东
Zhang Chengdong;Liu Qun;Jiang Haibin;Li Yandong(Department of Anesthesiology,the Affiliated Hospital of Jining Medical College,Shandong Jining 272000,China)
出处
《中国医师进修杂志》
2021年第10期939-943,共5页
Chinese Journal of Postgraduates of Medicine
作者简介
通信作者:李彦东,Email:mzklyd@163.com,电话:18678766855。
