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膝关节镜手术患者内收肌管阻滞与静脉注射双氯芬酸镇痛效果的比较评估

Comparative Evaluation of Analgesic Efficacy of Adductor Canal Block Versus Intravenous Diclofenac in Patients Undergoing Knee Arthroscopic Surgery.

作者信息

Ramanathan Aishwarya, Meena Dharam Singh, Nagalingam Natarajan, Gopalakrishnan Kuppusamy

机构信息

Department of Anaesthesiology, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India.

Department of Anaesthesiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

出版信息

Anesth Essays Res. 2021 Apr-Jun;15(2):157-160. doi: 10.4103/aer.aer_43_21. Epub 2021 Nov 7.

Abstract

BACKGROUND

Adductor canal block is a new and promising approach for providing postoperative pain relief in arthroscopic knee surgery.

AIM

The aim is to compare the postoperative analgesic efficacy of adductor canal block and intravenous (i.v.) diclofenac in patients undergoing knee arthroscopic surgeries.

SET AND DESIGN

This was a prospective, randomized double-blinded comparative study comprising 60 American Society of Anesthesiologists Physical status Classes I and II patients posted for unilateral knee arthroscopic surgery.

MATERIALS AND METHODS

Patients were randomized into two groups of 30 patients each. Patients were given general anaesthesia with fentanyl, propofol, and vecuronium. Ultrasound (USG) guided adductor canal block with 30 ml of 0.5% ropivacaine was given in Group A patients and patients in Group B received i.v. diclofenac before extubation. After adequate recovery, patients were shifted to postanesthetic care unit. Visual Analogue Scale score was assessed at rest, on standing and on walking 3 m.

STATISTICAL ANALYSIS

Student's independent -test was employed for comparing continuous variables. Chi-square test or Fisher's exact test, whichever is appropriate, was applied for comparing categorical variables.

RESULTS

The mean duration of analgesia was longer in Group A as compared to Group B and mean consumption of rescue analgesic was lower in Group A. Both were statistically significant. No significant postoperative complications or local side effects related to the block were noted.

CONCLUSIONS

Adductor canal block provides a longer duration of postoperative analgesia promotes early mobilization and has a good safety profile in unilateral knee arthroscopic surgeries.

摘要

背景

内收肌管阻滞是一种为膝关节镜手术提供术后疼痛缓解的新的且有前景的方法。

目的

目的是比较内收肌管阻滞与静脉注射双氯芬酸在接受膝关节镜手术患者中的术后镇痛效果。

设置与设计

这是一项前瞻性、随机双盲对照研究,纳入60例美国麻醉医师协会身体状况分级为I级和II级、拟行单侧膝关节镜手术的患者。

材料与方法

患者被随机分为两组,每组30例。患者接受芬太尼、丙泊酚和维库溴铵全身麻醉。A组患者接受超声引导下的内收肌管阻滞,注射30 ml 0.5%罗哌卡因,B组患者在拔管前接受静脉注射双氯芬酸。充分恢复后,患者被转至麻醉后护理单元。在静息、站立和行走3米时评估视觉模拟量表评分。

统计分析

采用学生独立t检验比较连续变量。采用卡方检验或Fisher精确检验(视情况而定)比较分类变量。

结果

与B组相比,A组的平均镇痛持续时间更长,A组的补救性镇痛药平均消耗量更低。两者均具有统计学意义。未观察到与阻滞相关的明显术后并发症或局部副作用。

结论

在内侧膝关节镜手术中,内收肌管阻滞提供更长时间的术后镇痛,促进早期活动且安全性良好。

相似文献

本文引用的文献

1
Adductor canal block for knee surgical procedures: review article.用于膝关节手术的收肌管阻滞:综述文章
J Clin Anesth. 2016 Dec;35:295-303. doi: 10.1016/j.jclinane.2016.08.021. Epub 2016 Oct 11.

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