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单侧脊髓麻醉与腰大肌间隙坐骨神经阻滞对全膝关节置换术后疼痛管理的影响

The Effect of Unilateral Spinal Anaesthesia and Psoas Compartment with Sciatic Block on the Postoperative Pain Management in Total Knee Artroplastic Surgery.

作者信息

Canakci Ebru, Unal Dogus, Guzel Yunus

机构信息

Department of Anesthesiology, Ordu University, School of Medicine, Ordu, Turkey.

Department of Anesthesiology, Ordu State Hospital, Ordu, Turkey.

出版信息

Pain Res Manag. 2017;2017:4127424. doi: 10.1155/2017/4127424. Epub 2017 Jan 31.

Abstract

. This study was designed to investigate the effects of peripheral nerve block methods, applied through unilateral spinal anaesthesia on elderly patients to undergo total knee arthroplasty, on perioperative hemodynamic parameters and postoperative analgesia period. . 60 patients were randomly divided into two groups in the study. In group USA spinal anaesthesia was performed. In group PCS it was applied on psoas compartment block and sciatic nerve block. . Significantly higher intraoperative 60th and 90th minute mean arterial pressure values were ascertained in the PCS group compared to the USA group. The decrease observed in the 5th, 10th, and 20th minute MAP values in the USA group was statistically significant according to the control MAP value. Concerning within group comparisons, the decrease in 5th, 10th, and 20th minute heart rate values in the USA group was statistically significant compared with the control measurement value. The mean beginning time of sensory and motor blocks in the PCS group was found to be at a significantly advanced level compared with that in the USA group. . The PCS block technique using bupivacaine hydrochloride ensured a higher haemodynamic efficiency in the perioperative period in high-risk elderly patients undergoing total knee arthroplasty. This trial is registered with ClinicalTrials.gov Identifier: NCT03021421.

摘要

本研究旨在探讨通过单侧脊髓麻醉对接受全膝关节置换术的老年患者应用外周神经阻滞方法,对围手术期血流动力学参数及术后镇痛期的影响。本研究将60例患者随机分为两组。美国组采用脊髓麻醉。腰大肌间隙阻滞联合坐骨神经阻滞组(PCS组)采用相应阻滞方法。与美国组相比,PCS组术中第60分钟和第90分钟平均动脉压值显著更高。根据对照平均动脉压值,美国组第5分钟、第10分钟和第20分钟平均动脉压值的下降具有统计学意义。在组内比较方面,美国组第5分钟、第10分钟和第20分钟心率值的下降与对照测量值相比具有统计学意义。发现PCS组感觉和运动阻滞的平均开始时间比美国组显著提前。在接受全膝关节置换术的高危老年患者围手术期,使用盐酸布比卡因的PCS阻滞技术确保了更高的血流动力学效率。本试验已在ClinicalTrials.gov注册,标识符:NCT03021421。

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