【摘要】：目的評價全膝關(guān)節(jié)置換術(shù)后于手術(shù)切口局部行持續(xù)浸潤麻醉鎮(zhèn)痛的有效性及安全性。方法將2015年8月至2016年5月共48例于西南醫(yī)科大學附屬中醫(yī)醫(yī)院行初次單側(cè)膝關(guān)節(jié)置換的患者按系統(tǒng)隨機抽樣法分為3組:對照組16例患者術(shù)后未行手術(shù)切口的局部持續(xù)浸潤麻醉及股神經(jīng)阻滯鎮(zhèn)痛,16例患者術(shù)后接受術(shù)側(cè)股神經(jīng)阻滯鎮(zhèn)痛(CFNB)組,16例患者術(shù)后行手術(shù)切口局部羅哌卡因持續(xù)浸潤麻醉鎮(zhèn)痛(CWI)組。對比3組患者術(shù)前一般情況、術(shù)后1~3d運動及靜息時手術(shù)部位的疼痛視覺模擬評分(VAS)、術(shù)后早期功能恢復情況及術(shù)后并發(fā)癥情況。結(jié)果所有患者均獲得隨訪,3組患者在術(shù)前一般情況及術(shù)后并發(fā)癥方面差異無統(tǒng)計學意義(P0.05);術(shù)后1~3d運動狀態(tài)下及術(shù)后第1天靜息狀態(tài)下VAS評分CWI組及CFNB組情況相似,均低于對照組,差異有統(tǒng)計學意義(P0.05);CWI組患者術(shù)后早期功能恢復情況優(yōu)于對照組及CFNB組。結(jié)論全膝關(guān)節(jié)置換術(shù)后于手術(shù)切口局部行持續(xù)浸潤麻醉鎮(zhèn)痛可減少患者術(shù)后疼痛,促進患者術(shù)后早期功能鍛煉及康復,提高患者滿意度。
[Abstract]:Objective to evaluate the efficacy and safety of continuous infiltration anesthesia in local incision after total knee arthroplasty. Methods from August 2015 to May 2016, 48 patients with primary unilateral knee arthroplasty were randomly divided into 3 groups: control group (n = 16) without surgical incision. Local continuous infiltration anesthesia and femoral nerve block analgesia, 16 patients received lateral femoral nerve block analgesia (CFNB) group) and 16 patients received local ropivacaine anesthesia (CWI) group) after operation. The patients were divided into two groups: control group (n = 16) and (CWI) group (n = 16). The early functional recovery and postoperative complications were compared among the three groups before operation, 1 day after operation and 3 days at rest. The pain visual analogue score (VAS),) was used to evaluate the early functional recovery and postoperative complications of the patients in the three groups. Results all the patients were followed up. There was no significant difference in the general situation before operation and postoperative complications among the three groups (P0.05). The VAS scores in CWI group and CFNB group were similar to those in control group at 1-3 days after operation and at rest on the first day after operation, and the difference was statistically significant (P0.05). The early functional recovery of); CWI group was better than that of control group and CFNB group (P0.05). Conclusion continuous infiltration anesthesia after total knee arthroplasty can reduce postoperative pain, promote early functional exercise and recovery, and improve patient satisfaction.
【作者單位】： 西南醫(yī)科大學附屬中醫(yī)醫(yī)院麻醉科;四川省瀘州市中醫(yī)院骨關(guān)節(jié)科;
【基金】：四川省衛(wèi)生廳科研課題(130274) 四川省瀘州市科研課題[2011-I-S41(4/4)]
【分類號】：R614

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