Department of Joint and Sport Medicine, Tianjin Union Medical Center, PR China.
Department of Anesthesiology, Tianjin Union Medical Center, PR China.
Medicine (Baltimore). 2021 Jan 22;100(3):e23978. doi: 10.1097/MD.0000000000023978.
Medial compartment femoro-tibial osteoarthritis (OA) is a common disease and opening-wedge high tibial osteotomy (OWHTO) is the common surgical procedure carried out for these patients. While most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the pain control effect of femoral nerve block (FNB) for OWHTO patients.
In this prospective, single-center, randomized controlled trial (RCT) study, 41 patients were operated on by OWHTO for OA during 2017 to 2018. Twenty of them (group A) accepted epidural anesthesia with FNB and 21 patients (group B) only had their single epidural anesthesia. All blocks were successful and all the 41 patients recruited were included in the analysis and there was no loss to follow-up or withdrawal. Systematic records of visual analog scores (VAS), quadriceps strength, mean number of times of patient-controlled intravenous analgesia (PCIA), using of additional opioids or nonsteroidal anti-inflammatory drugs (NSAIDs), and complications were done after hospitalization. The Student t test and Chi-Squared test was used and all P values ≤.05 were considered statistically significant.
VAS scores at rest (3.48 ± 1.0 vs 4.68 ± 1.1) and on movemment (4.51 ± 0.6 vs 4.97 ± 0.8) decreased more in group A than group B with significance at follow-up of 12 hours. The quadriceps strength, consumption of additional opioids or NSAID injections and mean number of times that the patients pushed the PCIA button didnot differ significantly within each group.
This RCT study shows that FNB in patients undergoing OWHTO for unicompartmental osteoarthritis of the knee could result in significant reduction in VAS scores at 12 hours postoperatively.Research registry, Researchregistry4792. Registered April 7, 2019 - Retrospectively registered, http://www.researchregistry.com.
膝关节内侧间室股胫骨骨关节炎（OA）是一种常见疾病，对于这些患者，开放式楔形胫骨高位截骨术（OWHTO）是常见的手术治疗方法。虽然大多数研究人员都在关注手术过程中的手术技术，但本研究的目的是评估股神经阻滞（FNB）对 OWHTO 患者的疼痛控制效果。
在这项前瞻性、单中心、随机对照试验（RCT）研究中，2017 年至 2018 年期间，41 例 OA 患者接受了 OWHTO 手术。其中 20 例（A 组）接受硬膜外麻醉联合 FNB，21 例（B 组）仅接受单一硬膜外麻醉。所有阻滞均成功，所有 41 例患者均纳入分析，无失访或退出。术后住院期间系统记录视觉模拟评分（VAS）、股四头肌力量、患者自控静脉镇痛（PCIA）次数、额外使用阿片类药物或非甾体抗炎药（NSAIDs）的次数和并发症。采用 Student t 检验和卡方检验，所有 P 值≤0.05 被认为具有统计学意义。
A 组患者静息时（3.48±1.0 比 4.68±1.1）和活动时（4.51±0.6 比 4.97±0.8）的 VAS 评分下降更明显，12 小时随访时差异有统计学意义。两组间股四头肌力量、额外使用阿片类药物或 NSAIDs 注射的次数和患者按压 PCIA 按钮的平均次数差异均无统计学意义。
这项 RCT 研究表明，膝关节单侧 OA 行 OWHTO 术的患者行 FNB 可显著降低术后 12 小时的 VAS 评分。
Researchregistry4792. 2019 年 4 月 7 日注册-回顾性注册，http://www.researchregistry.com。
