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隐神经阻滞是一种用于半月板切除术后疼痛的有效区域技术。

Saphenous nerve block is an effective regional technique for post-menisectomy pain.

作者信息

Akkaya Taylan, Ersan Onder, Ozkan Derya, Sahiner Yeliz, Akin Mine, Gümüş Haluk, Ateş Yalim

机构信息

Anesthesiology and Reanimation Department, Diskapi Yildirim Beyazit Training Hospital, Ankara, Turkey.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2008 Sep;16(9):855-8. doi: 10.1007/s00167-008-0572-4. Epub 2008 Jun 24.

Abstract

In this study we have evaluated the post menisectomy pain relief offered by Saphenous nerve block. This study was planned on 40 patients with a pre-operative and post operative diagnosis of medial meniscus lesion undergoing partial menisectomy arthroscopically. Patients were randomized into 2 groups where Group I received a preoperative Saphenous block while group 2 did not receive a peripheral block, but received 1 ml of saline as placebo injection. After blocks both groups received general anesthesia and IV patient controlled analgesia (PCA) with tramadol for post operative pain relief. Patients rest and activity pain scores were evaluated on post operative 0, 2, 4, 6, 12 and 24 h using visual analog scale (VAS). Total tramadol consumption as well as pain at rest, when weight bearing and the need for external support while walking were recorded. Group I VAS scores were statistically lower then group II during the time of observation periods at rest as well as active movement periods. Tramadol consumption through IV PCA was statistically significantly lower in group I than in group II (P < 0.05). Pain during walking measured at 24 h was significantly different with better results in group I (P < 0.001). Saphenous nerve block is used for different indications; it can also be a good analgesic method for arthroscopic interventions. We have shown it to be effective after medial partial menisectomies. According to our knowledge this report is the first one utilizing saphenous nerve block for pain after arthroscopic medial menisectomy.

摘要

在本研究中,我们评估了隐神经阻滞对半月板切除术后疼痛的缓解作用。本研究纳入了40例经术前和术后诊断为内侧半月板损伤并接受关节镜下部分半月板切除术的患者。患者被随机分为2组,其中第1组在术前接受隐神经阻滞,而第2组未接受外周阻滞,而是接受1 ml生理盐水作为安慰剂注射。阻滞操作后,两组均接受全身麻醉和静脉自控镇痛(PCA),使用曲马多缓解术后疼痛。在术后0、2、4、6、12和24小时,使用视觉模拟量表(VAS)评估患者休息和活动时的疼痛评分。记录曲马多的总消耗量以及休息时、负重时的疼痛情况,以及行走时对外部支撑的需求。在观察期内,第1组的VAS评分在休息和活动期均显著低于第2组。第1组通过静脉PCA使用的曲马多消耗量在统计学上显著低于第2组(P < 0.05)。在24小时测量的行走时疼痛在两组间有显著差异(P < 0.001),第1组效果更好。隐神经阻滞用于不同的适应证;它也可以是关节镜干预的一种良好镇痛方法。我们已经证明它在内侧部分半月板切除术后是有效的。据我们所知,本报告是第一篇关于关节镜下内侧半月板切除术后使用隐神经阻滞镇痛的报道。

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