The Department of Anesthesia and Pain Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Road Youyi Road, Yuanjiagang Community, Yuzhong District, Chongqing 400016, China.
Institute of Clinical Trials, The First Affiliated Hospital of Chongqing Medical University, China.
Evid Based Complement Alternat Med. 2014;2014:569107. doi: 10.1155/2014/569107. Epub 2014 Aug 28.
Objectives. To evaluate the comparative analgesia effectiveness and safety of postoperative continuous femoral nerve block (CFNB) with patient controlled intravenous analgesia (PCIA) and their impact on knee function and chronic postoperative pain. Methods. Participants were randomly allocated to receive postoperative continuous femoral nerve block (group CFNB) or intravenous patient controlled analgesia (group PCIA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for knee and incidence of chronic postoperative pain at 3, 6, and 12 months postoperatively were compared. postoperative pain and salvage medication at rest or during mobilization 24 hours, 48 hours, and 7 days postoperatively were also recorded. Results. After discharge from the hospital and rehabilitation of joint function, patients in group CFNB reported significantly improved knee flexion and less incidence of chronic postoperative pain at 3 months and 6 months postoperatively (P < 0.05). Analgesic rescue medications were significantly reduced in patients receiving CFNB (P < 0.001 and P = 0.031, resp.). Conclusion. With standardized rehabilitation therapy, continuous femoral nerve block analgesia reduced the incidence of chronic postoperative pain, improved motility of replaced joints, and reduced the dosages of rescue analgesic medications, suggesting a recovery-enhancing effect of peripheral nerve block analgesia.
目的。评估术后连续股神经阻滞（CFNB）与患者自控静脉镇痛（PCIA）的镇痛效果和安全性比较，及其对膝关节功能和慢性术后疼痛的影响。方法。参与者被随机分配接受术后连续股神经阻滞（CFNB 组）或静脉患者自控镇痛（PCIA 组）。比较术后膝关节的西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分以及术后 3、6 和 12 个月慢性术后疼痛的发生率。还记录了术后 24 小时、48 小时和 7 天的静息和活动时的术后疼痛和抢救性药物使用情况。结果。出院后进行关节功能康复，CFNB 组患者术后 3 个月和 6 个月时膝关节弯曲度明显改善，慢性术后疼痛发生率较低（P < 0.05）。接受 CFNB 的患者的镇痛抢救药物明显减少（P < 0.001 和 P = 0.031，分别）。结论。在标准化康复治疗的基础上，连续股神经阻滞镇痛降低了慢性术后疼痛的发生率，改善了置换关节的活动度，减少了抢救性镇痛药物的剂量，提示周围神经阻滞镇痛具有促进康复的作用。
