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不同浓度氯普鲁卡因股神经阻滞对全膝关节置换术后早期康复训练的影响。

Effect of Femoral Nerve Block with Different Concentrations of Chloroprocaine on Early Postoperative Rehabilitation Training After Total Knee Arthroplasty.

机构信息

Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China (mainland).

Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China (mainland).

出版信息

Med Sci Monit. 2023 Aug 23;29:e939858. doi: 10.12659/MSM.939858.

Abstract

BACKGROUND Patients experience severe pain in early postoperative rehabilitation after total knee arthroplasty (TKA). This study aimed to compare the effect of femoral nerve block with different concentrations of chloroprocaine on postoperative rehabilitation in patients with TKA. MATERIAL AND METHODS Ninety patients who only received unilateral TKA were randomly and equally divided into C1 (1% chloroprocaine 0.2 ml/kg), C2 (2% chloroprocaine 0.2 ml/kg), or NS (0.9% sodium chloride solution 0.2 ml/kg) groups. The patients received rehabilitation 3 times a day on days 3-6 after surgery, and femoral nerve block was performed with corresponding solution 10 min before each training session. We recorded the maximum knee flexion angles (MKFA) and maximum knee extension angles (MKEA) during active exercise on day 7 after surgery, as well as the incidence of MKFA ³100°, American knee society (AKS) scores, and postoperative rehabilitation satisfaction. Adverse effects after administration in each group were also recorded. RESULTS Compared with group NS, patients in group C1 and C2 had larger MKFA during active exercise on day 7 after TKA, and had better rehabilitation satisfaction (P<0.05). MKEA, the incidence of MKFA ≥100°, and AKS scores showed no significant differences in the 3 groups. There were more patients with decline of muscle strength in group C2 (P<0.05), and no other adverse reactions were recorded. CONCLUSIONS Chloroprocaine for femoral nerve block can be safely used in rehabilitation after TKA and to improve the knee flexion angle in the early postoperative period. Because they may have fewer adverse effects, 1% chloroprocaine 0.2 ml/kg may be preferred.

摘要

背景

全膝关节置换术(TKA)后早期康复阶段,患者会经历严重疼痛。本研究旨在比较不同浓度氯普鲁卡因用于 TKA 术后康复的效果。

材料与方法

90 例仅接受单侧 TKA 的患者被随机均分为 C1(1%氯普鲁卡因 0.2ml/kg)、C2(2%氯普鲁卡因 0.2ml/kg)或 NS(0.9%氯化钠溶液 0.2ml/kg)组。术后第 3-6 天,患者每天接受 3 次康复训练,每次训练前 10min 给予相应溶液行股神经阻滞。记录术后第 7 天主动运动时的最大膝关节屈曲角度(MKFA)和最大膝关节伸展角度(MKEA),以及 MKFA≥100°的发生率、美国膝关节协会(AKS)评分和术后康复满意度。记录各组不良反应。

结果

与 NS 组相比,C1 组和 C2 组患者在 TKA 后第 7 天的主动运动时的 MKFA 更大,康复满意度更高(P<0.05)。3 组间 MKEA、MKFA≥100°的发生率和 AKS 评分无显著差异。C2 组肌肉力量下降的患者更多(P<0.05),未记录到其他不良反应。

结论

股神经阻滞用氯普鲁卡因可安全用于 TKA 后康复,并可改善术后早期膝关节屈曲角度。因其可能不良反应更少,0.2ml/kg 的 1%氯普鲁卡因可能更优。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcc5/10461456/02047f121a0b/medscimonit-29-e939858-g001.jpg

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