Department of Anesthesiology, Nagoya Kyoritsu Hospital, Nagoya, Japan.
Korean J Anesthesiol. 2011 Nov;61(5):382-7. doi: 10.4097/kjae.2011.61.5.382. Epub 2011 Nov 23.
Venous thromboembolism (VTE) and the subsequent development of pulmonary embolism (PE) is a major cause of post-operative mortality in total knee arthroplasty (TKA). We evaluated whether the addition of an ultrasound-guided femoral nerve block with general anesthesia affected the incidence in the development of VTE following TKA.
This was a retrospective non-randomized comparative study with patients assigned to groups based on the surgery date (pre-femoral nerve block versus post-femoral nerve block periods). All anesthesia and medical records of the patients who had undergone computer-navigated TKA in our facility between January 2009 and March 2010 were retrospectively reviewed.
Forty patients were identified; 15 patients underwent computer-navigated TKA under general anesthesia alone (Group G) and 25 patients underwent surgery under general anesthesia combined with ultrasound-guided femoral nerve block (Group F). The incidence of development of VTE post-operatively was significantly lower in Group F (P = 0.037). Logistic regression analysis identified the use of a femoral nerve block as the most significant variable correlating with the incidence of post-operative development of VTE, and the odds ratio for VTE development in Group G was 3.12 (95% CI, 0.57-20.56).
We suggest the possibility that the addition of a femoral nerve block on general anesthesia may reduce the incidence of the development of VTE following TKA.
静脉血栓栓塞症（VTE）和随后的肺栓塞（PE）的发展是全膝关节置换术（TKA）术后死亡的主要原因。我们评估了全身麻醉下添加超声引导股神经阻滞是否会影响 TKA 后 VTE 的发生。
这是一项回顾性非随机对照研究，患者根据手术日期分为两组（股神经阻滞前组与股神经阻滞后组）。回顾性分析了 2009 年 1 月至 2010 年 3 月在我院行计算机导航 TKA 的所有患者的麻醉和医疗记录。
共确定了 40 例患者；15 例患者在全身麻醉下单独接受计算机导航 TKA（G 组），25 例患者在全身麻醉下联合超声引导股神经阻滞接受手术（F 组）。F 组术后 VTE 的发生率明显较低（P = 0.037）。Logistic 回归分析确定使用股神经阻滞是与术后 VTE 发生相关的最显著变量，G 组 VTE 发生的优势比为 3.12（95%CI，0.57-20.56）。
我们提出了全身麻醉下添加股神经阻滞可能降低 TKA 后 VTE 发展的可能性。
