| 王岩民 樊勇 高强 姚国华 刘振峰.不同局部浸润镇痛技术对前交叉韧带重建术后患者的镇痛效果[J].,2016,16(21):4058-4061 |
| 不同局部浸润镇痛技术对前交叉韧带重建术后患者的镇痛效果 |
| Analgesia Effect of Different Location Infiltration Analgesia in Patients afterAnterior Cruciate Ligament Reconstruction |
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| DOI： |
| 中文关键词: 局部浸润镇痛 前交叉韧带重建术 多模式镇痛 股神经阻滞 |
| 英文关键词: Infiltration analgesia Anterior Cruciate Ligament Reconstruction Multimodal Analgesia Femoral Nerve Block |
| 基金项目:新疆维吾尔自治区中医民族医药人才培养计划项目（Q2015-03-12） |
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| 中文摘要: |
| 目的：比较关节内与关节周围浸润镇痛对前交叉韧带重建术（ACLR）后患者的镇痛效果。方法：选择2014 年1 月至2015 年
11 月在我院拟行ACLR 的前交叉韧带断裂患者40 例，将其随机分为关节内浸润镇痛组（IA 组）与关节周围浸润镇痛组（PA组），
每组20 例。两组均于术前3d定时口服塞来昔布(200 mg，bid)，术前0.5 h行股神经阻滞(3.3g/L 罗哌卡因30 mL)。术中IA 组于关
节内给予30 mL复合镇痛药物，而PA组于关节周围滑膜内注射相同药物。术后均给予24 h冰敷治疗。观察两组患者术后12-72 h
及出院时的静息与活动疼痛视觉模拟评分(VAS)，术后24-72 h及出院时膝关节活动度，记录患者术后吗啡用量及不良反应情况。
结果：PA组术后12-72 h在静息与活动时以及在出院当天的活动时，VAS 评分均显著低于IA 组（P<0.05）。术后24-72h PA组关
节活动度均优于IA 组（P<0.05）。术后IA 组、PA组吗啡镇痛使用率分别为30%、15%，且IA 组吗啡平均用量为（10.3± 1.1）mg，明
显高于PA 组的（5.4± 0.9）mg（P<0.05）。两组不良反应率比较差异无统计学意义（P>0.05）。结论：关节周围浸润镇痛为主的多模式
镇痛对ACLR 围手术期患者的镇痛效果更好，更有利于关节功能的康复，值得临床推广应用。 |
| 英文摘要: |
| Objective:To compare the analgesia effect between Intra-articular and periarticular infiltration analgesia in patients after
anterior cruciate ligament reconstruction(ACRL).Methods:Selected 40 patients with anterior cruciate ligament rupture who were scheduled
to undergo ACLR in our hospital from January 2014 to November 2015, they were randomly divided into intra-articular infiltration
analgesia group (IA group, n=20)and periarticular infiltration analgesia group (PA group, n=20). All the patients were given Celecoxib
(200 mg, bid)at a definite time 3 d before the surgery, and underwent femoral nerve block (Ropivacaine 3.3 g/L, 30 mL)0.5 h before the
surgery. The IA group was given 30 mL combined analgesia drugs intra-articular, while the PA group was given the same drugs through
periarticular. Both the two groups were used ice therapy for 24 h after surgery. The Visual Analogue Scale(VAS)scores at rest and motion
in 12-72 h after surgery and on discharge day, as well as the range of motion in 24-72 h after surgery and on discharge day in two groups
were observed, the adverse reactions and postoperative morphine consumption were recorded.Results:The VAS scores in the PA group
were lower than IA group at rest(12-72 h)and motion(12 h to discharge day)after surgery(P<0.05). The range of motion in the PA group
were better than IA group in 24-72 h after surgery (P<0.05). The use rate of morphine analgesia in IA group and PA group were 30%,
15%respectively, and the average doses of morphine in IAgroup was(10.3± 1.1)mg, which was significantly higher than(5.4± 0.9)mg in
PA group (p<0.05). The adverse reactions of the two groups were no significant differences (P>0.05).Conclusion:In perioperative of
ACRL, periarticular infiltration analgesia-based multimodal analgesia can obtain a nice analgesic effect and promote the rehabilitation of
joint, which worth being widely applied in clinical field. |
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