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全膝关节置换术后疼痛管理中股神经阻滞与闭孔神经阻滞的比较:一项随机对照试验方案

Femoral nerve block versus obturator nerve block for pain management after total knee replacement: A randomized controlled trial protocol.

作者信息

Zhang Wei, Lin Peng, Zhang Fuheng, Wang Ji

机构信息

Department of Orthopaedics, NO.971 Hospital of the People's Liberation Army Navy, Shangdong, China.

出版信息

Medicine (Baltimore). 2020 Sep 11;99(37):e21956. doi: 10.1097/MD.0000000000021956.

Abstract

BACKGROUND

Several studies reported short-term analgesic efficacy of obturator nerve block (ONB), as in comparison with the femoral nerve block (FNB) in the treatment of postoperative pain after the total knee replacement (TKR). The optimal method remains under debate. The purpose of our current work is to compare the safety and efficacy of FNB and ONB for postoperative analgesia after TKR.

METHODS

This prospective, randomized, and controlled study was performed from January 2018 to December 2019. It was authorized via the Institutional Review Committee in NO.971 Hospital of the People's Liberation Army Navy (2019-PLAN-132).Two hundred patients were divided randomly into 2 groups, the control group (n = 100) and study group (n = 100). The experimental group received FNB and control groups received ONB. Primary outcome included pain at different time point (Visual Analogue Scale score of anterior knee pain at rest and in motion). The Visual Analogue Scale scores were marked by patients themselves on a paper with a graduated line starting at 0 (no pain) and ending at 10 (the most painful). Opioid consumption was converted to equivalents of oral morphine uniformly for statistical analysis. Secondary outcomes included the knee range of motion, the hospital stay length as well as the postoperative complications such as pulmonary embolism and deep vein thrombosis.

RESULTS

Table 1 will show the clinical outcomes between the 2 groups.

CONCLUSION

This trial would provide an evidence for the use of different types of peripheral nerve blocks in TKR.

摘要

背景

多项研究报道了闭孔神经阻滞(ONB)的短期镇痛效果,将其与股神经阻滞(FNB)用于全膝关节置换术(TKR)后疼痛的治疗进行了比较。最佳方法仍存在争议。我们当前研究的目的是比较FNB和ONB用于TKR术后镇痛的安全性和有效性。

方法

这项前瞻性、随机对照研究于2018年1月至2019年12月进行。经中国人民解放军海军第九七一医院机构审查委员会批准(2019-PLAN-132)。200例患者随机分为2组,对照组(n = 100)和研究组(n = 100)。实验组接受FNB,对照组接受ONB。主要结局包括不同时间点的疼痛情况(静息和活动时前膝疼痛的视觉模拟量表评分)。视觉模拟量表评分由患者自己在一张标有刻度线的纸上标记,刻度线从0(无疼痛)开始,到10(最疼痛)结束。阿片类药物的消耗量统一换算为口服吗啡当量进行统计分析。次要结局包括膝关节活动范围、住院时间以及术后并发症,如肺栓塞和深静脉血栓形成。

结果

表1将展示两组之间的临床结局。

结论

本试验将为TKR中使用不同类型的外周神经阻滞提供依据。

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