收肌管阻滞与关节腔周围注射在膝关节置换术后的镇痛效果比较(1)
摘要：目的 对膝关节置换术(TKA)实行超声引导下收肌管阻滞(U-ACB)，观察其镇痛效果。方法 选取我院2017年8月～2018年8月收治的80例拟行TKA的患者，随机将其分成对照组和观察组，各40例。对照组患者进行关节周围注射镇痛，观察组采用U-ACB镇痛。比较两组术后6、12、24、48 h股四头肌肌力分级情况、静息和运动时VAS评分情况及不良反应发生情况。结果 对照组术后6、12、24、48 h股四头肌肌力评分高于观察组，差异有统计学意义(P<0.05);静息时，对照组术后6、12、24、48 hVAS评分高于观察组，差异有统计学意义(P<0.05);运动时，两组术后6、12、24、48 hVAS评分比较，差异无统计学意义(P>0.05);对照组不良反应发生率高于观察组(15.00% vs 2.50%)，差异有统计学意义(P<0.05)。结论 U-ACB有利于TKA术后镇痛效果的提高，安全性较高，值得应用。
关键词：收肌管阻滞;关节腔周围注射;膝关节置换;术后镇痛
, 百拇医药
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.07.037
文章编号：1006-1959(2019)07-0123-03
Abstract：Objective To observe the analgesic effect of knee-to-articular replacement (TKA) under ultrasound-guided musculoskeletal block (U-ACB). Methods 80 patients with TKA who were admitted to our hospital from August 2017 to August 2018 were randomly divided into control group and observation group， 40 cases each. Patients in the control group underwent analgesia around the joints， and the observation group used U-ACB analgesia. The muscle strength of the quadriceps muscles at 6， 12， 24， and 48 h after operation， the VAS scores at rest and exercise， and the incidence of adverse reactions were compared. Results In the control group， the quadriceps muscle strength scores at 6， 12， 24， and 48 h after operation were higher than those in the observation group (P<0.05). At rest， the control group was 6， 12， 24，48 hVAS after surgery score was higher than that of the observation group，the difference was statistically significant (P<0.05). There was no significant difference in the VAS scores between the two groups at 6， 12， 24， and 48 h after exercise (P>0.05). The incidence of adverse reactions was higher than that of the observation group (15.00% vs 2.50%)，the difference was statistically significant (P<0.05). Conclusion U-ACB is beneficial to the analgesic effect of TKA， and it is safe and worthy of application.
, 百拇医药
Key words：Muscle block;Injection around the joint cavity;Knee replacement;Postoperative analgesia
目前膝關节置换术(TKA)是非感染性膝关节疾病治疗的有效方法，但是据相关报道称，有>60%的患者在术后会出现中度或重度疼痛，术后剧烈疼痛不仅会影响患者早期活动，同时还会对治疗效果产生至关重要的影响，因此TKA术后患者疼痛管理非常重要[1-3]。TKA术后镇痛方法有全身药物镇痛、椎管内镇痛、关节周围局部浸润麻醉镇痛、超声引导下收肌管阻滞等，一般区域阻滞包括神经阻滞和关节腔周围注射。超声引导下收肌管阻滞可以满足TKA 术后镇痛的需要，并且对股四头肌肌力影响较小[4]。近年来大容量局部麻醉剂浸润技术在关节置换术后镇痛的应用越来越多，其优点是实施相对简单，并发症相对少[5，6]。为验证其效果，本次研究TKA患者为研究对象，比较收肌管阻滞与关节腔周围注射的镇痛效果，现报告如下。, 百拇医药(王疆 殷积慧)
关键词：收肌管阻滞;关节腔周围注射;膝关节置换;术后镇痛
, 百拇医药
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.07.037
文章编号：1006-1959(2019)07-0123-03
Abstract：Objective To observe the analgesic effect of knee-to-articular replacement (TKA) under ultrasound-guided musculoskeletal block (U-ACB). Methods 80 patients with TKA who were admitted to our hospital from August 2017 to August 2018 were randomly divided into control group and observation group， 40 cases each. Patients in the control group underwent analgesia around the joints， and the observation group used U-ACB analgesia. The muscle strength of the quadriceps muscles at 6， 12， 24， and 48 h after operation， the VAS scores at rest and exercise， and the incidence of adverse reactions were compared. Results In the control group， the quadriceps muscle strength scores at 6， 12， 24， and 48 h after operation were higher than those in the observation group (P<0.05). At rest， the control group was 6， 12， 24，48 hVAS after surgery score was higher than that of the observation group，the difference was statistically significant (P<0.05). There was no significant difference in the VAS scores between the two groups at 6， 12， 24， and 48 h after exercise (P>0.05). The incidence of adverse reactions was higher than that of the observation group (15.00% vs 2.50%)，the difference was statistically significant (P<0.05). Conclusion U-ACB is beneficial to the analgesic effect of TKA， and it is safe and worthy of application.
, 百拇医药
Key words：Muscle block;Injection around the joint cavity;Knee replacement;Postoperative analgesia
目前膝關节置换术(TKA)是非感染性膝关节疾病治疗的有效方法，但是据相关报道称，有>60%的患者在术后会出现中度或重度疼痛，术后剧烈疼痛不仅会影响患者早期活动，同时还会对治疗效果产生至关重要的影响，因此TKA术后患者疼痛管理非常重要[1-3]。TKA术后镇痛方法有全身药物镇痛、椎管内镇痛、关节周围局部浸润麻醉镇痛、超声引导下收肌管阻滞等，一般区域阻滞包括神经阻滞和关节腔周围注射。超声引导下收肌管阻滞可以满足TKA 术后镇痛的需要，并且对股四头肌肌力影响较小[4]。近年来大容量局部麻醉剂浸润技术在关节置换术后镇痛的应用越来越多，其优点是实施相对简单，并发症相对少[5，6]。为验证其效果，本次研究TKA患者为研究对象，比较收肌管阻滞与关节腔周围注射的镇痛效果，现报告如下。, 百拇医药(王疆 殷积慧)