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联合坐骨神经和腰丛神经阻滞用于髋关节镜手术的镇痛管理:一项回顾性研究

Combined Sciatic and Lumbar Plexus Nerve Blocks for the Analgesic Management of Hip Arthroscopy Procedures: A Retrospective Review.

作者信息

Jaffe J Douglas, Morgan Theodore Ross, Russell Gregory B

出版信息

J Pain Palliat Care Pharmacother. 2017 Jun;31(2):121-125. doi: 10.1080/15360288.2017.1313355. Epub 2017 May 10.

Abstract

Hip arthroscopy is a minimally invasive alternative to open hip surgery. Despite its minimally invasive nature, there can still be significant reported pain following these procedures. The impact of combined sciatic and lumbar plexus nerve blocks on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy was investigated. A retrospective analysis of 176 patients revealed that compared with patients with no preoperative peripheral nerve block, significant reductions in pain scores to 24 hours were reported and decreased opioid consumption during the post anesthesia care unit (PACU) stay was recorded; no significant differences in opioid consumption out to 24 hours were discovered. A subgroup analysis comparing two approaches to the sciatic nerve block in patients receiving the additional lumbar plexus nerve block failed to reveal a significant difference for this patient population. We conclude that peripheral nerve blockade can be a useful analgesic modality for patients undergoing hip arthroscopy.

摘要

髋关节镜检查是开放性髋关节手术的一种微创替代方法。尽管其具有微创性,但据报道,这些手术后仍可能存在明显疼痛。本研究调查了坐骨神经和腰丛神经联合阻滞对接受髋关节镜检查患者术后疼痛评分和阿片类药物消耗量的影响。对176例患者的回顾性分析显示,与术前未进行外周神经阻滞的患者相比,术后24小时内疼痛评分显著降低,且麻醉后监护病房(PACU)停留期间阿片类药物消耗量减少;但在术后24小时内,阿片类药物消耗量没有显著差异。在接受额外腰丛神经阻滞的患者中,比较两种坐骨神经阻滞方法的亚组分析未发现该患者群体存在显著差异。我们得出结论,外周神经阻滞对于接受髋关节镜检查的患者可能是一种有用的镇痛方式。

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