Chen Juan, Wang Xiaowei
Department of Anesthesia, Handan Central Hospital, Hebei, China.
Medicine (Baltimore). 2021 Jan 22;100(3):e23895. doi: 10.1097/MD.0000000000023895.
Several previous trials have attempted to compare the efficacy of femoral nerve block (FNB) and local infiltrative analgesia (LIA) for patients received anterior cruciate ligament (ACL) reconstruction, but reached inconsistent conclusions. The primary purpose of this present research was to compare the FNB and LIA in the reconstruction of ACL.
This investigation was conducted and then reported on the basis of Strengthening the Reporting of Observational studies in the Epidemiology checklist. From our registry database, we retrospectively determined 688 patients who received the primary reconstruction of ACL from 2016 to 2019 at our academic institutions. This current retrospective cohort study was approved through the institutional review committee at our hospital. Inclusion criteria contained the primary or autograft bone-patellar tendine-bone reconstruction of ACL in the patients over 16 years of age. Patients in the LIA group underwent intraoperative infiltration at the harvested site after tendon harvest, with use of 2 mg/mL of ropivacaine 20 mL and 5 mg/mL of epinephrine, respectively. After the reconstruction of ACL, 5 Lg/mL of epinephrine, and 20 mL of ropivacaine (2 mg/mL) were injected at the site of surgical trauma. The patient in FNB group was given 40 mL of ropivacaine (2 mg/mL), and the ropivacaine was injected into femoral nerve sheath at femoral triangle level. The primary outcome was the consumption of morphine 24 h after the operation. And the secondary results involved the complications, functional results, and the scores of pain.
It is assumed that the efficacy of LIA in the early postoperative pain is no less than that of FNB. For our study, the major limitation is the lack of randomization. Nevertheless, these data were prospectively harvested, with high response rate of patient.
This study protocol was registered in Research Registry (researchregistry6277).
此前有多项试验试图比较股神经阻滞（FNB）与局部浸润镇痛（LIA）在前交叉韧带（ACL）重建患者中的疗效，但得出的结论并不一致。本研究的主要目的是比较FNB和LIA在ACL重建中的效果。
本研究依据加强流行病学观察性研究报告清单进行并报告。从我们的登记数据库中，我们回顾性确定了2016年至2019年在我们学术机构接受ACL初次重建的688例患者。这项回顾性队列研究已通过我院机构审查委员会的批准。纳入标准包括16岁以上患者的ACL初次或自体骨-髌腱-骨重建。LIA组患者在肌腱采集后于采集部位进行术中浸润，分别使用2mg/mL的罗哌卡因20mL和5mg/mL的肾上腺素。ACL重建后，在手术创伤部位注射5μg/mL的肾上腺素和20mL罗哌卡因（2mg/mL）。FNB组患者给予40mL罗哌卡因（2mg/mL），并将罗哌卡因注入股三角水平的股神经鞘内。主要结局是术后24小时吗啡的消耗量。次要结果包括并发症、功能结果和疼痛评分。
假设LIA在术后早期疼痛方面的疗效不低于FNB。对于我们的研究，主要局限性是缺乏随机分组。尽管如此，这些数据是前瞻性收集的，患者的反应率较高。
本研究方案已在研究注册库（researchregistry6277）注册。
