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华西医学  2014 

超声引导下收肌管阻滞与股神经阻滞对全膝关节置换术后镇痛的影响

DOI: 10.7507/1002-0179.20140675, PP. 2231-2235

Keywords: 全膝关节置换术,收肌管阻滞,股神经阻滞,术后镇痛,膝关节功能恢复

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Abstract:

目的 比较超声引导下收肌管阻滞(ACB)与股神经阻滞(FNB)对全膝关节置换术(TKA)患者术后镇痛及术后患肢运动功能恢复情况的影响。方法 2014年3月-4月将40例全身麻醉下拟行TKA手术的患者随机分为FNB镇痛组(FNB组)和ACB镇痛组(ACB组),每组20例。在全身麻醉诱导前,两组患者分别接受超声引导下的FNB和ACB。记录两组患者术中及术后阿片类镇痛药物使用量、术后静息和活动时的疼痛评分、股四头肌肌力、术后膝关节活动度和术后并发症发生率等。结果 ACB组患者术中及术后阿片类药物使用量、术后各观察点静息及运动时疼痛评分与FNB组比较,差异均无统计学意义(P>0.05);术后2~48h各观察时间点股四头肌肌力ACB组均优于FNB组(P<0.05);术后患者首次直腿抬高时间及各观察点膝关节活动度ACB组均优于FNB组(P<0.05)。结论 对TKA患者来说,ACB与FNB有相当镇痛效果,同时对股四头肌肌力影响更小,从而促进患者早期活动和患肢功能恢复。

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