| 丁 杰,陈 根,崔同庆,解 强,桂 超,刘 哲,王志彬,冯学会,李 伟.基于加速康复外科理念的前交叉韧带重建术中麻醉方式的选择[J].,2021,(9):1644-1647 |
| 基于加速康复外科理念的前交叉韧带重建术中麻醉方式的选择 |
| The Selection of Anesthesia Mode in ACL Reconstruction Based on the Concept of ERAS |
| 投稿时间：2020-08-30 修订日期：2020-09-23 |
| DOI：10.13241/j.cnki.pmb.2021.09.009 |
| 中文关键词: 收肌管阻滞 股神经阻滞 前交叉韧带损伤 早期康复 关节镜手术 |
| 英文关键词: Adductor canal block Femoral nerve block Anterior cruciate ligament injury Early rehabilitation Arthroscopic surgery |
| 基金项目:国家体育总局科研基金项目（G2020） |
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| 中文摘要: |
| 摘要 目的：基于加速康复外科理念，比较分析收肌管阻滞和股神经阻滞两组麻醉方式术后早期反应，探讨其在ACL重建术中的应用。方法：选取符合手术条件的88名ACL损伤的患者，随机分为收肌管阻滞组和股神经阻滞组，手术均在全麻下由同一组医生实施，采用自体腘绳肌重建ACL。比较术后早期2h，4 h，8 h，24 h和48 h患者静息和主动活动时VAS评分；患者首次主动直腿抬高时间；首次自主下地时间；48 h内追加盐酸哌替啶的的人次数；以及不良反应的例数。分析比较两组麻醉方式在术后早期的不同。结果：收肌管阻滞组患者在术后首次直腿抬高的时间和首次自主下地时间两方面与股神经阻滞组相比较，差异有统计学意义（P＜0.05）；两组患者在术后2 h，4 h，8 h，24 h和48 h静息和主动活动时疼痛程度以及48 h内追加盐酸哌替啶的人次数和不良反应的例数之间差异无统计学意义（P＞0.05）。结论：收肌管阻滞能够满足ACL重建术后的早期康复需要，在术后早期对股四头肌的影响较小，有助于患者早期康复，是一种安全、有效的麻醉方式。 |
| 英文摘要: |
| ABSTRACT Objective: According to enhanced recovery after surgery, by comparing and analyzing the early reaction after anesthesia in the two groups of adductor canal block and femoral nerve block, to explore its application in ACL reconstruction. Methods: 88 patients with ACL injury who met the surgical conditions were randomly divided into two groups: adductor canal block group and femoral nerve block group. The surgery was performed by the same group of doctors under general anesthesia, and the ACL was reconstructed using autologous hamstring. In the early postoperative period, the VAS score was used to evaluate the pain level of patients at rest and active at 2 h, 4 h, 8 h, 24 h and 48 h; the first time of raising his leg after the operation; the first time of leaving the sickbed; the number of people who added pethidine hydrochloride within 48 hours and the number of adverse reactions. Analyze and compare the difference between the two groups in the early postoperative period. Results: Compared with the femoral nerve block group, the first time of raising his leg after the operation and the first time of leaving the sickbed in the adductor block group were statistically different (P<0.05). There was no statistical difference between the two groups in the pain level of patients at rest and active after operation 2 h, 4 h, 8 h, 24 h and 48 h; the number of people who added pethidine hydrochloride within 48 hours and the number of adverse reactions (P>0.05). Conclusion: Adductor canal block plays a good role in anesthesia during ACL reconstruction. In the early postoperative period, adductor block is a safe and effective anesthesia method for ACL reconstruction and has little effect on quadriceps femoris, can help patients early rehabilitation. |
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