本文關(guān)鍵詞： 超聲 神經(jīng)刺激器 連續(xù)股神經(jīng)阻滯 全膝關(guān)節(jié)置換術(shù)　出處：《中國(guó)矯形外科雜志》2015年03期 　論文類型：期刊論文

【摘要】：[目的]比較不同方式引導(dǎo)下股神經(jīng)連續(xù)阻滯(PCNA)在全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛效果和并發(fā)癥及對(duì)康復(fù)功能的影響。[方法]全身麻醉下行單側(cè)膝關(guān)節(jié)置換術(shù)患者60例,隨機(jī)分為三組(n=20):超聲引導(dǎo)組(U組)、神經(jīng)刺激儀組(S組)、超聲聯(lián)合神經(jīng)刺激儀雙重引導(dǎo)組(D組),觀察3組患者術(shù)后的鎮(zhèn)痛效果、穿刺成功時(shí)間與次數(shù)及并發(fā)癥,術(shù)后6、12、24 h及48 h不同時(shí)間點(diǎn)VAS評(píng)分。[結(jié)果]D組和U組成功完成操作的穿刺次數(shù)明顯少于S組(P0.05),D組和U組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);從準(zhǔn)備穿刺到完成操作所需的時(shí)間三組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后6 h VAS評(píng)分,D組優(yōu)于S組和U組(P0.05),其余各時(shí)間點(diǎn)比較三組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后鎮(zhèn)痛泵的按壓次數(shù),D組少于U組和S組(P0.05),U組和S組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后S組有5例出現(xiàn)穿刺部位皮下淤血,U組和D組無(wú)并發(fā)癥發(fā)生。[結(jié)論]超聲聯(lián)合神經(jīng)刺激器技術(shù)引導(dǎo)股神經(jīng)阻滯,其穿刺的安全性和準(zhǔn)確性優(yōu)于單獨(dú)一項(xiàng)技術(shù)的使用,且兩種技術(shù)的聯(lián)合操作未見穿刺時(shí)間的延長(zhǎng),應(yīng)用于全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛有其優(yōu)越性。
[Abstract]:[objective] to compare the analgesic effect, complications and rehabilitation function of continuous femoral nerve block PCNA guided by different methods after total knee arthroplasty. [methods] Sixty patients with unilateral knee arthroplasty under general anesthesia were treated. Three groups were randomly divided into three groups: group U, group S and group D, respectively. The analgesic effect, the time and times of successful puncture and complications were observed. (results) the puncture times of group D and group U were significantly less than those of group S (P 0.05) and group U (P 0.05). There was no significant difference among the three groups (P 0.05). The VAS score of group D was better than that of group S and group U at 6 hours postoperatively, but there was no significant difference between the three groups at other time points. The times of postoperative analgesia pump in group D were less than those in group U and group S. There was no significant difference between group A (P 0.05) and group S (P 0.05). There were no complications in group S (5 cases) after operation. [conclusion] Ultrasound combined with nerve stimulator can lead to femoral nerve block. The safety and accuracy of the puncture is better than that of a single technique, and the combined operation of the two techniques has no prolongation of the puncture time, so it has its superiority in analgesia after total knee arthroplasty.
【作者單位】： 山東省濰坊市人民醫(yī)院麻醉科;
【分類號(hào)】：R614

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