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全膝关节置换术后镇痛中,除连续股神经阻滞外,超声引导下闭孔神经阻滞与坐骨神经阻滞的比较

Ultrasound guided obturator versus sciatic nerve block in addition to continuous femoral nerve block for analgesia after total knee arthroplasty.

作者信息

Sato Keita, Sai Seijyu, Shirai Naoto, Adachi Takehiko

机构信息

Department of Anesthesiology, Kitano Hospital, Ohgimachi, Kita-ku, Osaka, Japan.

出版信息

Jpn Clin Med. 2011 Jul 11;2:29-34. doi: 10.4137/JCM.S7399. Print 2011.

Abstract

Both obturator and sciatic nerve block in combination with femoral nerve block (FNB) have been suggested to be useful in relieving pain after total knee arthroplasty (TKA), compared with FNB alone. We compared their efficacy in this retrospective study. For six consecutive months, patients undergoing unilateral TKA under general anesthesia with continuous FNB plus obturator nerve block (n = 8) or continuous FNB plus sciatic nerve block (n = 8) were investigated. Knee pain was assessed using visual analogue scale (VAS) on the day of surgery and on postoperative days one to three. In addition, we also investigated intraoperative and postoperative morphine consumption. VAS scores and total morphine consumption were not different between the two groups, although patients in the FNB plus sciatic nerve block group were administered less morphine during surgery. Sciatic nerve block with continuous FNB may be superior to obturator nerve block with continuous FNB for analgesia during surgery for TKA.

摘要

与单纯股神经阻滞(FNB)相比,闭孔神经和坐骨神经阻滞联合股神经阻滞已被认为有助于缓解全膝关节置换术(TKA)后的疼痛。我们在这项回顾性研究中比较了它们的疗效。连续六个月,对在全身麻醉下行单侧TKA并接受连续FNB加闭孔神经阻滞(n = 8)或连续FNB加坐骨神经阻滞(n = 8)的患者进行了调查。在手术当天以及术后第1至3天使用视觉模拟量表(VAS)评估膝关节疼痛。此外,我们还调查了术中和术后吗啡的消耗量。两组之间的VAS评分和吗啡总消耗量没有差异,尽管FNB加坐骨神经阻滞组的患者在手术期间使用的吗啡较少。对于TKA手术期间的镇痛,连续FNB联合坐骨神经阻滞可能优于连续FNB联合闭孔神经阻滞。

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本文引用的文献

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