股外侧皮神经阻滞联合股神经阻滞在前交叉韧带重建术中的应用:一项前瞻性试验。
Usefulness of lateral femoral cutaneous nerve block in combination with femoral nerve block for anterior cruciate ligament reconstruction: a prospective trial.
机构信息
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-0934, Japan.
出版信息
Arch Orthop Trauma Surg. 2021 Mar;141(3):455-460. doi: 10.1007/s00402-020-03724-9. Epub 2021 Jan 2.
INTRODUCTION
The study aimed to compare the combination of femoral nerve block (FNB) with interspace between the popliteal artery and the capsule of posterior knee (IPACK) block (IPACK group) with the combination of FNB with lateral femoral cutaneous nerve (LFCN) block (LFCN group) for postoperative pain control in patients undergoing anterior cruciate ligament (ACL) reconstruction. We hypothesized that the lower pain scores and decreased suppository use would be noted in patients administered a combination of FNB and IPACK block.
MATERIALS AND METHODS
A non-randomized prospective controlled clinical trial was conducted. The IPACK and LFCN groups included 40 patients each. The patients received IPACK block and LFCN block alternately. Thirty minutes prior to the surgery and after administration of general anesthesia, patients received an ultrasound-guided FNB and IPACK block or LFCN block. After ACL reconstruction, the visual analog scale pain scores were recorded at 30 min, 4 h, 8 h, 12 h, 24 h, 48 h, and 72 h after the surgery. The administration and use of analgesic suppositories were assessed. These measures were compared among the treatment types at each time-point using the Welch's t-test.
RESULTS
Suppository use was significantly less in the LFCN group than in the IPACK group. The pain scores were significantly lower in the LFCN group at 30 min, 4 h, 48 h, and 72 h after the surgery.
CONCLUSION
The combination of FNB with LFCN block during ACL reconstruction significantly reduces pain in the early postoperative period compared to a combination of FNB with IPACK block.
LEVEL OF EVIDENCE
Prospective control trial, Level II.
介绍
本研究旨在比较股神经阻滞(FNB)联合膝关节后囊与腘窝间隙阻滞(IPACK)(IPACK 组)与 FNB 联合股外侧皮神经阻滞(LFCN)(LFCN 组)在接受前交叉韧带(ACL)重建的患者中的术后疼痛控制效果。我们假设接受 FNB 和 IPACK 联合阻滞的患者疼痛评分更低,栓剂使用量更少。
材料和方法
进行了一项非随机前瞻性对照临床试验。IPACK 和 LFCN 组各包括 40 例患者。患者轮流接受 IPACK 阻滞和 LFCN 阻滞。在手术前 30 分钟和全身麻醉后,患者接受超声引导下的 FNB 和 IPACK 阻滞或 LFCN 阻滞。ACL 重建后,在术后 30 分钟、4 小时、8 小时、12 小时、24 小时、48 小时和 72 小时记录视觉模拟评分疼痛评分。评估镇痛栓剂的使用情况。使用 Welch's t 检验比较不同治疗类型在每个时间点的这些指标。
结果
LFCN 组的栓剂使用率明显低于 IPACK 组。术后 30 分钟、4 小时、48 小时和 72 小时,LFCN 组的疼痛评分明显更低。
结论
与 FNB 联合 IPACK 阻滞相比,ACL 重建期间 FNB 联合 LFCN 阻滞可显著减轻术后早期疼痛。
证据水平
前瞻性对照试验,II 级。