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全膝关节置换术后股神经阻滞与股外侧肌间隙阻滞的疗效比较。

Comparison of the efficacy of femoral nerve block and fascia iliaca compartment block in patients with total knee replacement.

机构信息

Department of Anesthesiology and Reanimation, Gaziosmanpaşa University, Tokat, Turkey -

Department of Anesthesiology and Reanimation, Gaziosmanpaşa University, Tokat, Turkey.

出版信息

Minerva Anestesiol. 2018 Oct;84(10):1134-1141. doi: 10.23736/S0375-9393.18.12062-1. Epub 2018 Jan 16.

DOI:10.23736/S0375-9393.18.12062-1
PMID:29338141
Abstract

BACKGROUND

Blocking the femoral nerve reduces postoperative pain and analgesic consumption in patients who have undergone total knee and hip replacement surgery. A limited number of studies have compared the efficacy of the fascia iliaca compartment and femoral nerve block techniques. Therefore, this study aimed to investigate the analgesic effectiveness of fascia iliaca compartment block (FIB) and femoral nerve block using ultrasound.

METHODS

A total of 100 patients were included in the study. Patients were divided into two randomized and equal groups (Group I had patients who underwent fascia iliaca compartment block, N.=50; Group II had patients who underwent femoral nerve block, N.=50). Visual Analogue Scale levels (VAS) in the postoperative 30th min and 1st, 2nd, 6th, 12th and 24th hours and the amounts of analgesic consumption were recorded. The Quality of Recovery-40 (QoR-40) questionnaire was completed by patients 24 hours after surgery.

RESULTS

The VAS level at the 24th hour was significantly lower in Group I compared to Group II. Analgesic consumption between 0-30th minutes was lower in Group II than in Group I; however, it was significantly lower in the 6-24 hours of Group I compared to Group II. The QoR-40 score was found to be significantly higher in Group I than Group II.

CONCLUSIONS

Femoral nerve block provided more potent analgesia in the first six hours after operation. After six hours, FIB demonstrated better pain control. The quality of postoperative recovery was higher in patients with fascia iliaca compartment block.

摘要

背景

在接受全膝关节和髋关节置换手术的患者中,阻断股神经可减少术后疼痛和镇痛药的消耗。为数不多的研究比较了阔筋膜张肌间隙和股神经阻滞技术的疗效。因此,本研究旨在探讨超声引导下阔筋膜张肌间隙阻滞(FIB)和股神经阻滞的镇痛效果。

方法

共有 100 名患者纳入本研究。患者被分为两组(每组 50 名):接受阔筋膜张肌间隙阻滞的组(I 组)和接受股神经阻滞的组(II 组)。记录术后 30 分钟和 1、2、6、12 和 24 小时的视觉模拟评分(VAS)水平以及镇痛药的使用量。术后 24 小时,患者完成 40 项康复质量问卷(QoR-40)。

结果

与 II 组相比,I 组在 24 小时时的 VAS 水平显著降低。II 组在 0-30 分钟内的镇痛药物消耗低于 I 组;然而,I 组在 6-24 小时内的镇痛药物消耗明显低于 II 组。I 组的 QoR-40 评分明显高于 II 组。

结论

股神经阻滞在术后前 6 小时提供更强的镇痛效果。6 小时后,FIB 表现出更好的疼痛控制效果。接受阔筋膜张肌间隙阻滞的患者术后恢复质量更高。

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