Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth PL6 8DH, United Kingdom.
J Arthroplasty. 2012 Dec;27(10):1806-11. doi: 10.1016/j.arth.2012.05.018. Epub 2012 Jul 5.
This study tests the null hypothesis that there is no difference between sciatic nerve block (SNB) and periarticular anesthetic infiltration (PI) as adjuncts to femoral nerve blockade (FNB) in total knee arthroplasty in terms of postoperative opioid requirements. Fifty-two patients undergoing total knee arthroplasty were randomized to receive either (a) combined FNB-SNB or (b) combined FNB-PI. Average morphine consumption in the first 24 (20 vs 23 mg) and 48 hours (26 vs 33 mg) showed no significant difference. Visual Analogue Scale scores, knee flexion (60° vs 67.5°) and extension lag (0° vs 5°) were comparable. Anesthetic time, surgical time, and length of hospital stay (5.5 vs 6 days) were similar. This study showed no significant difference between the 2 groups. The PI offers a practical and potentially safer alternative to SNB.
本研究旨在检验下述无效假设，即在全膝关节置换术中，与股神经阻滞（FNB）联合应用时，坐骨神经阻滞（SNB）和关节周围麻醉浸润（PI）在术后阿片类药物需求方面无差异。52 例行全膝关节置换术的患者随机分为两组，分别接受（a）联合 FNB-SNB 或（b）联合 FNB-PI。术后 24 小时（20 毫克 vs 23 毫克）和 48 小时（26 毫克 vs 33 毫克）的平均吗啡消耗量无显著差异。视觉模拟评分、膝关节屈曲（60° vs 67.5°）和伸直延迟（0° vs 5°）相似。麻醉时间、手术时间和住院时间（5.5 天 vs 6 天）相似。本研究显示两组之间无显著差异。PI 为 SNB 提供了一种实用且潜在更安全的替代方法。
