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全髋关节置换术后连续三合一股神经阻滞与关节周围多模式药物浸润联合治疗

Combination Therapy with Continuous Three-in-One Femoral Nerve Block and Periarticular Multimodal Drug Infiltration after Total Hip Arthroplasty.

作者信息

Tetsunaga Tomonori, Tetsunaga Tomoko, Fujiwara Kazuo, Endo Hirosuke, Ozaki Toshifumi

机构信息

Department of Orthopaedics, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan; Department of Orthopaedics, Okayama Medical Center, 1711-1 Tamasu, Kitaku, Okayama 701-1192, Japan.

Department of Orthopaedics, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan.

出版信息

Pain Res Manag. 2016;2016:1425201. doi: 10.1155/2016/1425201. Epub 2016 Dec 14.

Abstract

. Various postoperative pain relief modalities, including continuous femoral nerve block (CFNB), local infiltration analgesia (LIA), and combination therapy, have been reported for total knee arthroplasty. However, no studies have compared CFNB with LIA for total hip arthroplasty (THA). The aim of this study was to compare the efficacy of CFNB versus LIA after THA. . We retrospectively reviewed the postoperative outcomes of 93 THA patients (20 men, 73 women; mean age 69.2 years). Patients were divided into three groups according to postoperative analgesic technique: CFNB, LIA, or combined CFNB+LIA. We measured the following postoperative outcome parameters: visual analog scale (VAS) for pain at rest, supplemental analgesia, side effects, mobilization, length of hospital stay, and Harris Hip Score (HHS). . The CFNB+LIA group had significantly lower VAS pain scores than the CFNB and LIA groups on postoperative day 1. There were no significant differences among the three groups in use of supplemental analgesia, side effects, mobilization, length of hospital stay, or HHS at 3 months after THA. . Although there were no clinically significant differences in outcomes among the three groups, combination therapy with CFNB and LIA provided better pain relief after THA than CFNB or LIA alone, with few side effects.

摘要

. 全膝关节置换术已有多种术后疼痛缓解方式的报道,包括连续股神经阻滞(CFNB)、局部浸润镇痛(LIA)及联合治疗。然而,尚无研究比较全髋关节置换术(THA)中CFNB与LIA的效果。本研究旨在比较THA后CFNB与LIA的疗效。. 我们回顾性分析了93例THA患者(20例男性,73例女性;平均年龄69.2岁)的术后结果。根据术后镇痛技术将患者分为三组:CFNB组、LIA组或CFNB + LIA联合组。我们测量了以下术后结果参数:静息时疼痛的视觉模拟评分(VAS)、辅助镇痛、副作用、活动情况、住院时间及Harris髋关节评分(HHS)。. CFNB + LIA组在术后第1天的VAS疼痛评分显著低于CFNB组和LIA组。THA术后3个月时,三组在辅助镇痛的使用、副作用、活动情况、住院时间或HHS方面无显著差异。. 尽管三组结果在临床上无显著差异,但CFNB与LIA联合治疗在THA后比单独使用CFNB或LIA能提供更好的疼痛缓解,且副作用较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f41/5192331/04f09ed25063/PRM2016-1425201.001.jpg

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