本文選題：收肌管阻滯 + 小型關(guān)節(jié)鏡手術(shù)　； 參考：《實(shí)用醫(yī)學(xué)雜志》2017年05期

【摘要】：目的:探討超聲引導(dǎo)下收肌管阻滯應(yīng)用于各種小型膝關(guān)節(jié)鏡手術(shù)術(shù)后鎮(zhèn)痛的效果。方法:擇期行小型關(guān)節(jié)鏡手術(shù)患者60例,隨機(jī)分為收肌管阻滯組(ACB組)和對照組(C組),每組30例。ACB組患者在手術(shù)結(jié)束后行超聲引導(dǎo)下收肌管阻滯,注入0.5%羅哌卡因20 m L。在術(shù)后4、8、12、24 h時(shí)應(yīng)用視覺模擬評分法(VAS)對患肢膝關(guān)節(jié)部位的靜息狀態(tài)及被動屈膝時(shí)的疼痛程度進(jìn)行評分并記錄,同時(shí)記錄術(shù)后24 h下地步行5 m的患者人數(shù),使用哌替啶的次數(shù)及總量、發(fā)生惡心嘔吐、頭暈、尿潴留等鎮(zhèn)痛相關(guān)不良反應(yīng)的例數(shù)。結(jié)果:ACB組術(shù)后4、8、12 h的靜息疼痛和活動疼痛VAS評分低于對照組(P0.01)。術(shù)后24 h兩組患者均能下床行走5 m,對肌力無明顯影響。對照組有4例術(shù)后因疼痛需使用鎮(zhèn)痛藥,其中1例發(fā)生惡心嘔吐。結(jié)論:超聲引導(dǎo)下收肌管阻滯應(yīng)用于小型關(guān)節(jié)鏡手術(shù)術(shù)后,可以提供良好的鎮(zhèn)痛效果,且對肌力無明顯影響。
[Abstract]:Objective: to investigate the effect of ultrasonic-guided adductor block on postoperative analgesia of various small knee arthroscopic operations. Methods: sixty patients undergoing mini-arthroscopic surgery were randomly divided into adductor block group (ACB group) and control group (group C). 30 patients in ACB group were treated with ultrasound guided adductor canal block after operation, and 0.5% ropivacaine was injected with 20 mL. Visual analogue score (VAS) was used to evaluate the rest state of the knee joint and the pain degree of passive flexion at 24 h after operation. The number of patients who walked 5 m at 24 h after operation was recorded. The frequency and amount of pethidine use, nausea and vomiting, dizziness, urinary retention and other analgesic related adverse reactions. Results the VAS score of rest pain and active pain in the control group was lower than that in the control group (P 0.01). 24 h after operation, the patients in both groups were able to walk out of bed for 5 m and had no significant effect on muscle strength. In the control group, 4 cases needed analgesics because of postoperative pain, and 1 case developed nausea and vomiting. Conclusion: Ultrasound-guided adductor block can provide good analgesic effect after small arthroscopic surgery, and has no obvious effect on muscle strength.
【作者單位】： 蘭州大學(xué)第二臨床醫(yī)學(xué)院;蘭州軍醫(yī)總醫(yī)院;
【基金】：2015年甘肅省自然科學(xué)基金項(xiàng)目(編號:1506RJ-ZA305)
【分類號】：R687.4

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