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关节镜下前交叉韧带撕裂修复术后内收肌管阻滞与股神经阻滞用于术后镇痛的比较研究

Comparative Study of Adductor Canal Block and Femoral Nerve Block for Postoperative Analgesia After Arthroscopic Anterior Cruciate Ligament Tear Repair Surgeries.

作者信息

Dixit Amey, Prakash Ravi, Yadav Avtar S, Dwivedi Sudhakar

机构信息

Department of Anaesthesiology, Shyam Shah Medical College, Rewa, IND.

出版信息

Cureus. 2022 Apr 10;14(4):e24007. doi: 10.7759/cureus.24007. eCollection 2022 Apr.

Abstract

OBJECTIVE

The study aimed to compare an adductor canal block (ACB) with a femoral nerve block (FNB) with regard to their analgesic efficacy and the quadriceps muscle strength in patients following arthroscopic anterior cruciate ligament (ACL) tear repair surgeries.

MATERIALS AND METHODS

Ninety patients in the American Society of Anaesthesiologists (ASA) status I or II undergoing arthroscopic ACL tear repair surgeries under subarachnoid block were divided into three groups to receive ACB (Group ACB), FNB (Group FNB), and control (Group C). Each patient was assessed for Visual Analogue Scale (VAS) score, tramadol consumption, and quadriceps muscle strength postoperatively in the post anaesthesia care unit (PACU).

RESULTS

There was no significant difference between the Group ACB and Group FNB regarding postoperative analgesia and total rescue analgesic consumption at 24 hrs postoperative. The mean VAS score at two, four, and six hours and total rescue analgesic consumption in 24 hrs were higher in the control group, which was statistically significant (p-value <0.05). Quadriceps muscle strength by straight leg raise test was significantly higher in the Group ACB compared with the Group FNB at 0, 6, 12, 18 hours postoperatively (p-value <0.0001), whereas the difference between both study groups become statistically insignificant at 24 hours postoperative.

CONCLUSION

ACB preserved quadriceps muscle strength better than FNB, without a significant difference in postoperative analgesia after arthroscopic ACL tear repair surgeries.

摘要

目的

本研究旨在比较内收肌管阻滞(ACB)与股神经阻滞(FNB)在前交叉韧带(ACL)撕裂修复关节镜手术后患者的镇痛效果及股四头肌肌力方面的差异。

材料与方法

90例美国麻醉医师协会(ASA)分级为I或II级、在蛛网膜下腔阻滞下行ACL撕裂修复关节镜手术的患者被分为三组,分别接受ACB(ACB组)、FNB(FNB组)和对照组(C组)。在麻醉后护理单元(PACU)对每位患者术后的视觉模拟评分(VAS)、曲马多用量及股四头肌肌力进行评估。

结果

ACB组和FNB组在术后镇痛及术后24小时总补救性镇痛药物用量方面无显著差异。对照组在术后2、4和6小时的平均VAS评分及24小时总补救性镇痛药物用量更高,差异具有统计学意义(p值<0.05)。术后0、6、12、18小时,ACB组通过直腿抬高试验测得的股四头肌肌力显著高于FNB组(p值<0.0001),而在术后24小时,两组间差异无统计学意义。

结论

在ACL撕裂修复关节镜手术后,ACB在保留股四头肌肌力方面优于FNB,且术后镇痛效果无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df0/9090210/14d1a7f53f12/cureus-0014-00000024007-i01.jpg

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