中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2015年
8期
2016-2018
,共3页
单次%股神经阻滞%膝关节置换术%老年%镇痛%术后恢复
單次%股神經阻滯%膝關節置換術%老年%鎮痛%術後恢複
단차%고신경조체%슬관절치환술%노년%진통%술후회복
Femoral nerve block%Single shot%Total knee arthroplasty%Eldly patients%Postoperative analgesia%Rehabilitation
目的 观察单次股神经阻滞对膝关节置换术老年患者术后早期镇痛和恢复的影响.方法 40例择期拟行膝关节置换术的老年患者,年龄≥60岁,随机分为全身麻醉组(G组)和单次股神经阻滞联合全身麻醉组(GF组),每组20例.术后每例患者均行自控静脉镇痛.分别记录两组患者术后的拔管时间和清醒时间、术后6、12、24、48 h静息和运动状态疼痛视觉模拟评分(VAS),术后24、48 h患肢主动关节屈曲角度及不良反应的发生率.结果 GF组术后拔管时间和清醒时间、术后6、12h的静息状态VAS评分及术后12h的运动状态VAS评分分别是(7.4±1.8)、(11.3±2.9)、(24.0±11.0)、(26.0±15.0)、(34.0±20.0)分,显著低于G组的(10.4±2.5)、(18.7±3.2)、(36.0±13.0)、(37.0±16.0)、(45.0±21.0)分;GF组术后24、48 h患肢主动关节屈曲角度分别为(42.1±8.9)°、(54.1±8.2)°,显著大于G组的(31.3±7.5)°、(45.3±7.1)°,差异有统计学意义(P＜0.05).结论 术前单次股神经阻滞能显著改善膝关节置换术老年患者术后早期的镇痛和恢复效果.
目的 觀察單次股神經阻滯對膝關節置換術老年患者術後早期鎮痛和恢複的影響.方法 40例擇期擬行膝關節置換術的老年患者,年齡≥60歲,隨機分為全身痳醉組(G組)和單次股神經阻滯聯閤全身痳醉組(GF組),每組20例.術後每例患者均行自控靜脈鎮痛.分彆記錄兩組患者術後的拔管時間和清醒時間、術後6、12、24、48 h靜息和運動狀態疼痛視覺模擬評分(VAS),術後24、48 h患肢主動關節屈麯角度及不良反應的髮生率.結果 GF組術後拔管時間和清醒時間、術後6、12h的靜息狀態VAS評分及術後12h的運動狀態VAS評分分彆是(7.4±1.8)、(11.3±2.9)、(24.0±11.0)、(26.0±15.0)、(34.0±20.0)分,顯著低于G組的(10.4±2.5)、(18.7±3.2)、(36.0±13.0)、(37.0±16.0)、(45.0±21.0)分;GF組術後24、48 h患肢主動關節屈麯角度分彆為(42.1±8.9)°、(54.1±8.2)°,顯著大于G組的(31.3±7.5)°、(45.3±7.1)°,差異有統計學意義(P＜0.05).結論 術前單次股神經阻滯能顯著改善膝關節置換術老年患者術後早期的鎮痛和恢複效果.
목적 관찰단차고신경조체대슬관절치환술노년환자술후조기진통화회복적영향.방법 40례택기의행슬관절치환술적노년환자,년령≥60세,수궤분위전신마취조(G조)화단차고신경조체연합전신마취조(GF조),매조20례.술후매례환자균행자공정맥진통.분별기록량조환자술후적발관시간화청성시간、술후6、12、24、48 h정식화운동상태동통시각모의평분(VAS),술후24、48 h환지주동관절굴곡각도급불량반응적발생솔.결과 GF조술후발관시간화청성시간、술후6、12h적정식상태VAS평분급술후12h적운동상태VAS평분분별시(7.4±1.8)、(11.3±2.9)、(24.0±11.0)、(26.0±15.0)、(34.0±20.0)분,현저저우G조적(10.4±2.5)、(18.7±3.2)、(36.0±13.0)、(37.0±16.0)、(45.0±21.0)분;GF조술후24、48 h환지주동관절굴곡각도분별위(42.1±8.9)°、(54.1±8.2)°,현저대우G조적(31.3±7.5)°、(45.3±7.1)°,차이유통계학의의(P＜0.05).결론 술전단차고신경조체능현저개선슬관절치환술노년환자술후조기적진통화회복효과.
Objective To investigate the effects of single-shot femoral nerve block on postoperative analgesia and rehabilitation for the eldly patients undergoing total knee arthroplasty.Methods Forty patients older than 60 years scheduled for selective total knee arthroplasty were randomly divided into two groups (n =20):control group (group G) and single-shot femoral nerve block group (group GF).Before the induction of anesthesia,ultrasound-guided femoral nerve block was performed and 0.375 ％ ropivacaine 20 ml was injected in group GF.Every patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after the operation.The time of extubation and awareness were recorded.Pain at rest was evaluated using VAS score at 6,12,24 and 48 h after the operation.The moving VAS score at 12,24,48 h after the operation were also assessed.The maximal amplitude of knee flexion was measured when take exercises at 24,48 h after the operation.And the adverse reactions were also recorded.Results The time of extubation and awareness,the VAS score at rest at 6,12 h and the VASscore at movement at 12 h after the operation in group GF were 7.4 ± 1.8,11.3 ± 2.9,24.0 ± 11.0,26.0 ± 15.0,34.0 ± 20.0.Those in group G significantly lower (10.4 ± 2.5,18.7 ± 3.2,36.0 ± 13.0,37.0 ± 16.0,45.0 ± 21.0) than group GF (P ＜ 0.05).The maximal amplitude of knee flexion when movement at 24,48 h after the operation in group GF were (42.1 ± 8.9) °,(54.1 ± 8.2) °,significantly higher than those in group G [(31.3 ± 7.5) °,(45.3 ± 7.1) °,P ＜ 0.05].There were significant differences between two groups and the incidence of nausea and vomiting was significantly decreased in groups GF (P ＜ 0.05).Conclusion Single-shot femoral nerve block can improve the postoperative analgesia and rehabilitation for the eldly patients undergoing total knee arthroplasty.
