Said Nour Aliman El Majzoub, Mestriner Alexandre Barbieri, Sungaila Heloisa, Mameri Enzo Salviato, Franciozi Carlos Eduardo Silveira, Kubota Marcelo Seiji
Grupo do Joelho e Artroscopia, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Dec 21;59(6):e876-e882. doi: 10.1055/s-0044-1793825. eCollection 2024 Dec.
To compare the efficacy of fluoroscopy as an auxiliary method in genicular nerve block (GNB) with block guidance by anatomical parameters, without imaging aid, in reducing pain. A total of 23 patients underwent fluoroscopy-guided or anatomical parameter-based GNBs. We applied the Western Ontario and McMaster Universities' Osteoarthritis Index (WOMAC) and the Visual Analog Scale (VAS) for pain at 6 time points (preblock, and after 1 hour, 24 hours, 7 days, 28 days, and 90 days). The mean age of the sample was of 64.5 ± 4.8 years, and the mean Body Mass Index (BMI), of 31.4 ± 6.1 Kg/m ; 16 subjects (69.6%) were women. The WOMAC pain subscale showed a significant reduction ( < 0.05) in pain in both groups at all time points. This reduction was greater after 1 hour in both groups, with rates if 64.3% and 64.6% in the fluoroscopy and anatomical parameters groups respectively, with no significant difference. At the end of 90 days, the pain reduction rates were of 35.7% and 44.6% in the fluoroscopy and anatomical parameter groups respectively. The VAS also showed a significant reduction ( < 0.05) in pain in both groups at all times. The reduction was more significant after 1 hour: 78.0% in the fluoroscopy group and 82.2% in the anatomical parameter group, with no significant difference. At the end of 90 days, the pain reduction was of in the fluoroscopy group 36.5% and of 24.6% in the anatomical parameters group. The GNBs guided by fluoroscopy or by anatomical parameters alone were equally effective in terms of magnitude and duration of pain relief.
为比较在不借助成像辅助的情况下,使用荧光镜检查作为辅助方法在膝神经阻滞(GNB)中与基于解剖学参数的阻滞引导在减轻疼痛方面的疗效。共有23例患者接受了荧光镜引导或基于解剖学参数的GNB。我们在6个时间点(阻滞前、1小时后、24小时后、7天、28天和90天后)应用了西安大略和麦克马斯特大学骨关节炎指数(WOMAC)以及视觉模拟量表(VAS)来评估疼痛。样本的平均年龄为64.5±4.8岁,平均体重指数(BMI)为31.4±6.1kg/m²;16名受试者(69.6%)为女性。WOMAC疼痛子量表显示两组在所有时间点的疼痛均显著减轻(P<0.05)。两组在1小时后疼痛减轻更为明显,荧光镜检查组和解剖学参数组的减轻率分别为64.3%和64.6%,无显著差异。在90天结束时,荧光镜检查组和解剖学参数组的疼痛减轻率分别为35.7%和44.6%。VAS也显示两组在所有时间点的疼痛均显著减轻(P<0.05)。1小时后减轻更为显著:荧光镜检查组为78.0%,解剖学参数组为82.2%,无显著差异。在90天结束时,荧光镜检查组的疼痛减轻率为36.5%,解剖学参数组为24.6%。荧光镜引导或仅由解剖学参数引导的GNB在疼痛缓解的程度和持续时间方面同样有效。