Jansen Tammy K, Miller Brian E, Arretche Nicolas, Pellegrini Joseph E
Naval Hospital Twentynine Palms, California, USA.
AANA J. 2009 Jun;77(3):213-8.
Two common forms of postoperative analgesia used in patients following an anterior cruciate ligament repair (ACLR) are the femoral nerve block (FNB) and the combined femoral-sciatic nerve block (FSB). The purpose of this study was to determine if the addition of the sciatic nerve block to the FNB is truly beneficial in ACLR patients requesting regional anesthesia for postoperative pain control. All subjects scheduled for an ACLR, requesting general anesthesia and preoperative placement of a peripheral nerve block (PNB), were randomized to receive an FNB or an FSB. Analgesic requirements, pain scores, and overall postoperative analgesic satisfaction were the primary outcomes measured. The data for 56 subjects (FNB, 27; FSB, 29) were used in analysis. Significantly higher analgesic requirements, pain scores, and lower satisfaction scores were noted in the FNB group compared with the FSB group (P < .05). No other differences were noted between groups in demographic data. Based on this investigation, we concluded that the FSB, compared with FNB alone, provides superior postoperative analgesia in patients receiving an ACLR and should be included in the anesthetic care plan in which a PNB is planned to facilitate postoperative analgesia.
前交叉韧带重建术（ACLR）后患者常用的两种术后镇痛方式是股神经阻滞（FNB）和股-坐骨神经联合阻滞（FSB）。本研究的目的是确定在请求区域麻醉以控制术后疼痛的ACLR患者中，在FNB基础上加用坐骨神经阻滞是否真的有益。所有计划行ACLR、需要全身麻醉且术前需放置外周神经阻滞（PNB）的受试者被随机分为接受FNB或FSB组。主要测量指标为镇痛需求、疼痛评分和总体术后镇痛满意度。分析采用了56名受试者的数据（FNB组27名；FSB组29名）。与FSB组相比，FNB组的镇痛需求和疼痛评分显著更高，满意度评分更低（P<0.05）。两组在人口统计学数据方面未发现其他差异。基于本研究，我们得出结论，与单纯FNB相比，FSB在接受ACLR的患者中提供了更好的术后镇痛效果，应纳入计划采用PNB以促进术后镇痛的麻醉护理方案中。
