下肢连续外周神经阻滞与膝关节和髋关节置换术后患者跌倒的关系。
The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty.
机构信息
Department of Anesthesiology, University of California San Diego, San Diego, California, USA.
出版信息
Anesth Analg. 2010 Dec;111(6):1552-4. doi: 10.1213/ANE.0b013e3181fb9507. Epub 2010 Oct 1.
Abstract
BACKGROUND
Continuous peripheral nerve blocks (CPNB) may induce muscle weakness, and multiple recently published series emphasize patient falls after postarthroplasty CPNB. However, none have included an adequate control group, and therefore the relationship between CPNB and falls remains speculative.
METHODS
We pooled data from 3 previously published, randomized, triple-masked, placebo-controlled studies of CPNB involving the femoral nerve after knee and hip arthroplasty.
RESULTS
No patients receiving perineural saline (n = 86) fell (0%; 95% confidence interval [CI] = 0%-5%), but there were 7 falls in 6 patients receiving perineural ropivacaine (n = 85; 7%; 95% CI = 3%-15%; Fisher's exact test P = 0.013).
CONCLUSIONS
Our analysis suggests that there is a causal relationship between CPNB and the risk of falling after knee and hip arthroplasty.
摘要
背景
连续外周神经阻滞（CPNB）可能会导致肌肉无力，最近发表的多个系列强调了关节置换术后 CPNB 后患者跌倒的情况。然而，这些研究都没有包括足够的对照组，因此 CPNB 与跌倒之间的关系仍存在推测。
方法
我们汇集了 3 项先前发表的、随机的、三重盲的、安慰剂对照的 CPNB 研究的数据，这些研究涉及膝关节和髋关节置换术后的股神经。
结果
接受神经周围生理盐水（n = 86）的患者无跌倒（0%；95%置信区间 [CI] = 0%-5%），但接受神经周围罗哌卡因（n = 85；7%；95%CI = 3%-15%；Fisher 确切检验 P = 0.013）的 6 名患者中有 7 人跌倒。
结论
我们的分析表明，CPNB 与膝关节和髋关节置换术后跌倒的风险之间存在因果关系。
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