Department of Orthopaedic Surgery, NYU Langone Medical Center Hospital for Joint Diseases, 301E 17th St, New York, NY 10003, USA.
Arthroscopy. 2012 Aug;28(8):1064-9. doi: 10.1016/j.arthro.2012.01.003. Epub 2012 Apr 11.
To evaluate the utility of femoral nerve blocks in postoperative pain control after hip arthroscopy.
Forty consecutive patients scheduled for hip arthroscopy were randomized into 2 groups for postoperative pain control. Half were to receive routine intravenous narcotics for pain scores of 7 or above in the postanesthesia care unit (PACU), and the other half were to receive a femoral nerve block in the PACU for the same pain scores. Data were compared with respect to patient sex, patient age, traction times, type of procedure, nausea, overall patient satisfaction with analgesia, and duration of time in the PACU.
Thirty-six patients had initial pain scores of 7 of 10 or greater on a visual analog scale. Of these patients, 16 were randomized to receive postoperative morphine and 20 to receive a femoral nerve block. There were no significant differences between the 2 groups with respect to sex, age, traction times, or type of procedure performed. Patients who received morphine had a significantly longer time to discharge from the PACU (216 minutes) than the femoral nerve block group (177 minutes). The morphine group was also significantly more likely to report postoperative nausea (75%) than the femoral nerve block group (10%). Patients receiving femoral nerve blocks were significantly more likely to be satisfied with their postoperative pain control (90%) than those who had received morphine (25%). All of the patients receiving a femoral nerve block stated that they would undergo the block again if they needed another hip arthroscopy.
On the basis of all criteria studied (quality of pain relief, length of stay in the PACU, side effects, and patient satisfaction), a femoral nerve block is an excellent alternative to routine narcotic pain medication in patients undergoing hip arthroscopy.
Level II, randomized controlled trial.
评估股神经阻滞在髋关节镜术后疼痛控制中的作用。
连续 40 例拟行髋关节镜手术的患者随机分为 2 组，以控制术后疼痛。一半患者在麻醉后恢复室（PACU）中疼痛评分达到 7 或以上时接受常规静脉内阿片类药物治疗，另一半患者在 PACU 中接受股神经阻滞治疗相同的疼痛评分。比较患者性别、年龄、牵引时间、手术类型、恶心、患者对镇痛的总体满意度以及 PACU 停留时间。
36 例患者初始视觉模拟评分（VAS）为 10 分中的 7 分或更高。这些患者中，16 例随机接受术后吗啡治疗，20 例接受股神经阻滞治疗。两组在性别、年龄、牵引时间或手术类型方面无显著差异。接受吗啡的患者从 PACU 出院的时间明显长于股神经阻滞组（216 分钟）（177 分钟）。吗啡组术后恶心的发生率也明显高于股神经阻滞组（75%）（10%）。接受股神经阻滞的患者对术后疼痛控制的满意度明显高于接受吗啡的患者（90%）（25%）。所有接受股神经阻滞的患者均表示，如果需要再次进行髋关节镜手术，他们将再次接受阻滞。
根据所有研究标准（疼痛缓解质量、PACU 停留时间、副作用和患者满意度），股神经阻滞是髋关节镜手术患者常规阿片类药物治疗的一种极好替代方法。
II 级，随机对照试验。
