Tierney E, Lewis G, Hurtig J B, Johnson D
Department of Anaesthesia, Ottawa Civic Hospital, Ontario.
Can J Anaesth. 1987 Sep;34(5):455-8. doi: 10.1007/BF03014348.
An assessment was made, in a randomised double-blind fashion, of the pain relief afforded by femoral nerve block (FNB) performed at the end of ligament reconstruction of the knee, using 0.25 per cent bupivacaine in ten patients, and normal saline in ten patients. All patients commenced "continuous passive motion" (CPM) of the operated knee after arrival in the Recovery Room. The postoperative analgesic requirement, both for intravenous fentanyl in the Recovery Room, and intramuscular and oral analgesia on the ward, was then studied. The time interval between FNB and first dose of analgesia was significantly longer in the bupivacaine group than in the control group. The bupivacaine group also required significantly less intravenous fentanyl in the Recovery Room. On the ward, there was no difference between the two groups in the total dose of intramuscular meperidine given in the first 12 hours postoperatively. We conclude that femoral nerve block is a useful adjunct in pain management after ligament reconstruction of the knee, especially in the early postoperative period, but does not decrease the total intramuscular dose of analgesia in the first 12 postoperative hours.
采用随机双盲方式，对10例患者在膝关节韧带重建结束时使用0.25%布比卡因进行股神经阻滞（FNB）以及10例患者使用生理盐水进行股神经阻滞所提供的疼痛缓解效果进行了评估。所有患者在进入恢复室后均开始对手术膝关节进行“持续被动运动”（CPM）。随后研究了术后镇痛需求，包括在恢复室使用静脉注射芬太尼以及在病房使用肌肉注射和口服镇痛药物的情况。布比卡因组股神经阻滞至首次使用镇痛药物的时间间隔显著长于对照组。布比卡因组在恢复室所需的静脉注射芬太尼也显著较少。在病房，两组术后12小时内肌肉注射哌替啶的总剂量无差异。我们得出结论，股神经阻滞是膝关节韧带重建术后疼痛管理的一种有用辅助方法，尤其是在术后早期，但在术后12小时内并不能减少肌肉注射镇痛药物的总剂量。
