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收肌管阻滞在关节镜部分半月板切除术后康复质量方面与股神经阻滞相似。

Adductor canal block is similar to femoral nerve block for the quality of rehabilitation after arthroscopic partial meniscectomy.

机构信息

Department of Anesthesiology, West China Hospital of Sichuan University, No.37 Wai Nan Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 Jul;28(7):2334-2342. doi: 10.1007/s00167-019-05796-6. Epub 2019 Nov 29.

Abstract

PURPOSE

Adductor canal block (ACB) provides postoperative pain relief as effectively as femoral nerve block (FNB) does, and it preserves the strength of the quadriceps femoris. However, its effect on rehabilitation after arthroscopic partial meniscectomy has not been reported. The purpose of this study was to determine the effect of pre-operative ACB and FNB on the quality of rehabilitation after arthroscopic partial meniscectomy.

METHODS

A total of 150 patients undergoing arthroscopic partial meniscectomy were randomly allocated to the FNB group (receiving 0.3% ropivacaine 30 ml at the thighroot-femoral nerve), the ACB group (receiving 0.3% ropivacaine 30 ml at mid-thigh adductor canal), or the control group. The primary outcome was the Hospital for Special Surgery (HSS) knee score on the 30th postoperative day.

RESULTS

The HSS knee score of the ACB group on the 30th day after the operation was significantly higher than those of the FNB and control groups (88.6 ± 5.3 vs. 85.3 ± 6.9 and 81.2 ± 5.9, respectively; P < 0.05). Both the ACB and FNB groups showed excellent rehabilitation, indicating similar rehabilitation quality for both treatments.

CONCLUSION

ACB is similar to FNB concerning the quality of rehabilitation and pain relief after arthroscopic partial meniscectomy, while ACB has little effect on the strength of the quadriceps femoris.

LEVEL OF EVIDENCE

I TRIAL REGISTRATAION: This trial was registered in the Chinese Clinical Trial Registry (ChiCTR-INC-16008346).

摘要

目的

隐动脉阻滞(ACB)在提供术后镇痛方面与股神经阻滞(FNB)同样有效,并能保持股四头肌的力量。然而,其在关节镜下半月板部分切除术(APM)后的康复效果尚未见报道。本研究旨在确定术前 ACB 和 FNB 对关节镜下半月板部分切除术(APM)后康复质量的影响。

方法

共 150 例行关节镜下半月板部分切除术的患者随机分为 FNB 组(大腿根部-股神经处注射 0.3%罗哌卡因 30ml)、ACB 组(大腿中隐动脉阻滞注射 0.3%罗哌卡因 30ml)或对照组。主要结局是术后第 30 天的美国特种外科医院(HSS)膝关节评分。

结果

术后第 30 天,ACB 组的 HSS 膝关节评分明显高于 FNB 组和对照组(88.6±5.3 比 85.3±6.9 和 81.2±5.9,均 P<0.05)。ACB 组和 FNB 组的康复效果均为优,提示两种治疗方法的康复质量相似。

结论

ACB 在缓解关节镜下半月板部分切除术后疼痛和康复质量方面与 FNB 相似,而对股四头肌力量的影响较小。

证据水平

I 临床试验注册:本研究在中国临床试验注册中心(ChiCTR-INC-16008346)注册。

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