[1]陶小红,孟继红,潘亚娟,等.超声引导股神经阻滞与收肌管阻滞用于全膝关节置换术后镇痛的跌倒风险[J].介入放射学杂志,2021,30(01):34-38.
 TAO Xiaohong,MENG Jihong,PAN Yajuan,et al.Ultrasound-guided femoral nerve block versus adductor canal block for postoperative analgesia after total knee arthroplasty: comparison of the falling risk[J].journal interventional radiology,2021,30(01):34-38.
点击复制

超声引导股神经阻滞与收肌管阻滞用于全膝关节置换术后镇痛的跌倒风险()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年01
页码:
34-38
栏目:
非血管介入
出版日期:
2021-01-25

文章信息/Info

Title:
Ultrasound-guided femoral nerve block versus adductor canal block for postoperative analgesia after total knee arthroplasty: comparison of the falling risk
作者:
陶小红 孟继红 潘亚娟 单玉兰
Author(s):
TAO Xiaohong MENG Jihong PAN YajuanSHAN Yulan.
Department of Anesthesia and Surgery, Affiliated Haian Hospital, Nantong University,Nantong, Jiangsu Province 226600,China
关键词:
【关键词】 超声引导 股神经阻滞 收肌管阻滞 全膝关节置换
文献标志码:
A
摘要:
【摘要】 目的 探讨超声引导股神经阻滞与收肌管阻滞用于全膝关节置换术后镇痛的跌倒风险比较。方法 2016年11月至2019年11月将80例择期行单侧全膝关节置换的患者随机分为股神经阻滞组(39例)和收肌管阻滞组(41例)。两组患者在术后即刻接受基于持续收肌管阻滞和股神经阻滞的多模式镇痛。比较两组患者在术后24 h和48 h的Tinetti评分、肌力分级评分(MMT评分)、TUG(timed up and go test) 时间以及视觉模拟评分(VAS)和阿片类药物的使用剂量的变化。 结果 术后24 h和48 h,收肌管阻滞组的Tinetti评分以及评分<19分的患者比例显著优于股神经阻滞组(P<0.05);对于MMT评分和TUG时间,术后24 h,收肌管阻滞组显著优于股神经阻滞组(P<0.05),术后48 h,两组之间差异无显著的统计学意义(P>0.05);术后24 h和48 h两组患者的VAS评分及阿片类药物使用剂量差异无显著的统计学意义;两组患者均未出现超声引导阻滞操作相关的并发症。结论 超声引导下收肌管阻滞和股神经阻滞均可有效用于全膝关节置换后的术后镇痛,收肌管阻滞能更好地保存股四头肌肌力且与股神经阻滞相比,前者发生跌倒风险的显著降低。

参考文献/References:

[1] 冯宝莹,张习良,杜杰强. 连续股神经阻滞与静脉自控镇痛对全膝关节置换术后镇痛及Th1/Th2水平的影响[J]. 北京医学, 2019, 41:1079- 1082.
[2] Finn DM, Agarwal RR, Ilfeld BM, et al. Fall risk associated with continuous peripheral nerve blocks following knee and hip arthroplasty[J]. Medsurg Nurs, 2016, 25: 25- 30.
[3] 黄连军,陈永杰,李 扬,等. 收肌管阻滞与局部浸润镇痛对全膝关节置换术后患者早期镇痛效果的临床研究[J]. 北京医学, 2019, 41:667- 670.
[4] Rittenhouse KJ, To T, Rogers A, et al. Hyponatremia as a fall predictor in a geriatric trauma population[J]. Injury, 2015, 46: 119- 123.
[5] Kronzer VL, Wildes TM, Stark SL, et al. Review of perioperative falls[J]. Br J Anaesth, 2016, 117: 720- 732.
[6] Li DH, Tan Z, Kang P, et al. Effects of multi- site infiltration analgesia on pain management and early rehabilitation compared with femoral nerve or adductor canal block for patients undergoing total knee arthroplasty: a prospective randomized controlled trial[J]. Int Orthop, 2017, 41: 75- 83.
[7] Global RPH. The clinician’s ultimate reference[EB/OL].http://www.globalrph.com/narcoticonv.htm, 2015- 04- 25.
[8] Panella L, Tinelli C, Buizza A, et al . Towards objective evaluation of balance in the elderly: validity and reliability of a measurement instrument applied to the tinettitest[J]. Int J Rehabil Res, 2008, 31:65- 72.
[9] 黎 阳,刘金凤. 超声引导下神经阻滞在全膝关节置换术后镇痛中的研究进展[J]. 医学综述, 2019, 25:1431- 1437.
[10] Maulin UV, Nicholas TA, Kassel CA, et al. Adductor canal block for knee surgical procedures: review article[J]. J Clin Anesth, 2016, 35: 295- 303.
[11] Koh HJ, Koh IJ, Kim MS, et al. Does patient perception differ following adductor canal block and femoral nerve block in total knee arthroplasty? A simultaneous bilateral randomized study[J]. J Arthroplasty, 2017, 32: 1856- 1861.
[12] 苏日娜,孙 义,张析哲,等. 单次收肌管阻滞与连续股神经阻滞在全膝关节置换术后早期镇痛中的效应[J]. 内蒙古医科大学学报, 2019, 41:539- 541.
[13] Kwofie MK, Shastri UD, Gadsden JC, et al. The effects of ultrasound- guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers[J]. Reg Anesth Pain Med, 2013, 38: 321- 325.
[14] Soffin EM, Ya Deau JT. Enhanced recovery after surgery for primary hip and knee arthroplasty: a review of the evidence[J]. Br J Anaesth, 2016, 117(Suppl 3):iii62- iii72.
[15] Abdallah FW, Madjdpour C, Brull R. Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? A meta- analysis[J]. Can J Anaesth, 2016,63:552- 568.
[16] Memtsoudis SG, Dy CJ, Ma Y, et al. In- hospital patient falls after total joint arthroplasty: incidence, demographics, and risk factors in the United States[J]. J Arthroplasty, 2012, 27: 823- 828.
[17] Memtsoudis SG, Danninger T, Rasul R, et al. Inpatient falls after total knee arthroplasty: the role of anesthesia type and peripheral nerve blocks[J]. Anesthesiology, 2014, 120: 551- 563.
[18] Memtsoudis SG, Yoo D, Stundner O, et al. Subsartorial adductor canal vs femoral nerve block for analgesia after total knee replacement[J]. Int Orthop, 2015, 39: 673- 680.
[19] Zhen T, Kang PD, Pei FX, et al. A comparison of adductor canal block and femoral nerve block after total- knee arthroplasty regarding analgesic effect, effectiveness of early rehabilitation, and lateral knee pain relief in the early stage[J]. Medicine(Baltimore), 2018, 97: e13391.

相似文献/References:

[1]魏 炜,艾 红,阮郦韬.超声引导下乳腺小微病灶导丝定位的临床应用[J].介入放射学杂志,2015,(07):629.
 WEI Wei,AI Hong,RUAN Li- tao.Clinical application of preoperative ultrasound- guided guide- wire localization in diagnosing tiny breast lesions[J].journal interventional radiology,2015,(01):629.
[2]韦红霞,束晓霞,李斌义.聚桂醇在单纯性肾囊肿硬化治疗中的应用价值[J].介入放射学杂志,2016,(12):1094.
 WEI Hong- xia,SHU Xiao- xia,LI Bin- yi.The application value of lauromacrogol in sclerotherapy of simple renal cysts[J].journal interventional radiology,2016,(01):1094.
[3]董 亮,周 青,纪永利,等.超声与CT经皮穿刺在超声可视性胸部病变定性诊断中的对比研究[J].介入放射学杂志,2017,(08):718.
 DONG Liang,ZHOU Qing,JI Yongli,et al.Ultrasound- guided versus CT- guided percutaneous biopsy for the qualitative diagnosis of ultrasonic- visual chest lesions: a comparison study[J].journal interventional radiology,2017,(01):718.
[4]单玉兰,周晓林,朱小兰,等.超声引导下前锯肌阻滞与胸椎硬膜外阻滞治疗急性胸廓切开术后疼痛的疗效比较[J].介入放射学杂志,2020,29(05):472.
 SHAN Yulan,ZHOU Xiaolin,ZHU Xiaolan,et al.Ultrasound-guided serratus anterior plane block versus thoracic epidural block in the treatment of acute pain after thoracotomy[J].journal interventional radiology,2020,29(01):472.
[5]吴中俭,高明杰,谷涌泉,等.超声引导下定向斑块旋切联合药物涂层球囊治疗股浅动脉重度狭窄1例[J].介入放射学杂志,2020,29(07):736.
 WU Zhongjian,GAO Mingjie,GU Yongquan,et al.Successful treatment of severe stenosis of superficial femoral artery by using ultrasound-guided direct rotational atherectomy combined with drug-coating balloon dilatation: report of one case[J].journal interventional radiology,2020,29(01):736.
[6]李 晓,唐栋梁,王 洁,等.超声引导竖脊肌间隙阻滞与胸椎椎旁神经阻滞治疗乳腺癌术后急性疼痛疗效观察 [J].介入放射学杂志,2020,29(08):777.
 LI Xiao,TANG Dongliang,WANG Jie,et al.Ultrasound-guided erector spinae block and thoracic paravertebral block for the treatment of acute pain after surgery of breast cancer[J].journal interventional radiology,2020,29(01):777.
[7]王 懿,陈 沛,万光明.中长期静脉通路互联网平台的构建与应用[J].介入放射学杂志,2021,30(07):730.
 WANG Yi,CHEN Pei,WAN Guangming..Establishment and application of internet platform used for mid-to-long-term management of venous access[J].journal interventional radiology,2021,30(01):730.
[8]吉冬梅,徐小青,史传岗.超声引导膝关节腔注射对患者满意度、关节功能和生活质量的影响[J].介入放射学杂志,2021,30(10):1040.
 JI Dongmei,XU Xiaoqing,SHI Chuangang..Ultrasound-guided knee joint cavity injection: its effect on patient satisfaction, joint function and quality of life[J].journal interventional radiology,2021,30(01):1040.
[9]罗玮雯,李拾林,吕国荣,等.超声引导下经皮肺穿刺并发症及相关因素分析[J].介入放射学杂志,2021,30(12):1243.
 LUO Weiwen,LI Shilin,Lyu Guorong,et al.Ultrasound-guided percutaneous pulmonary puncture biopsy: analysis of complications and related factors[J].journal interventional radiology,2021,30(01):1243.
[10]钱朝庆,陈坤前,张国辉,等.超声引导下血管腔内缝合术在医源性股动脉假性动脉瘤的临床应用[J].介入放射学杂志,2022,31(12):1203.
 QIAN Chaoqing,CHEN Kunqian,ZHANG Guohui,et al.Clinical application of ultrasound-guided endovascular suture in treating iatrogenic femoral artery pseudoaneurysm[J].journal interventional radiology,2022,31(01):1203.

备注/Memo

备注/Memo:
(收稿日期:2020- 01- 30)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2021-01-25