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单注射内收肌管阻滞在单髁膝关节置换术中增强早期活动能力,镇痛效果与持续输注相当:一项回顾性队列研究。

Single-Injection Adductor Canal Block Enhances Early Mobilization with Comparable Analgesia to Continuous Infusion in Unicompartmental Knee Arthroplasty: A Retrospective Cohort Study.

作者信息

Lan Fei, Chong Yuhan, Liu Fangyan, Wang Tianlong

机构信息

Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.

出版信息

J Pain Res. 2025 Aug 1;18:3851-3858. doi: 10.2147/JPR.S512475. eCollection 2025.

Abstract

OBJECTIVE

Adductor canal block (ACB) is commonly used for postoperative analgesia after unicompartmental knee arthroplasty (UKA). However, the comparative benefits of single-injection ACB (SACB) versus continuous ACB (CACB) remain unclear.

METHODS

In our retrospective cohort study, patients undergoing unilateral, primary UKA were allocated to group CACB or group SACB from January 2016 to December 2023. The primary outcome was the visual analog scale (VAS) for pain. Secondary outcomes included the additional analgesic therapy, activity score, postoperative nausea and vomiting (PONV), complications, and length of stay (LOS).

RESULTS

After 1:1 propensity score matching based on age, sex, body mass index (BMI), and preoperative pain score, 35 patients were included in each group (SACB and CACB). At 24 hours postoperatively, the SACB group had a slightly higher VAS pain score compared with the CACB group, though this difference was not statistically significant. The Post-Anesthesia Care Unit (PACU) activity score was significantly higher in the SACB group ( = 0.02), and the LOS was significantly shorter by approximately 3 days compared to the CACB group ( < 0.001). No significant differences were found between groups in terms of additional analgesic therapy, Oxford Knee Score (OKS), PONV, or complications.

DISCUSSION

CACB did not significantly reduce postoperative pain or improve functional outcomes over three months after UKA compared to SACB. However, SACB was associated with improved immediate postoperative mobility and a shorter LOS, suggesting potential benefits for early recovery.

摘要

目的

收肌管阻滞(ACB)常用于单髁膝关节置换术(UKA)后的术后镇痛。然而,单次注射ACB(SACB)与持续ACB(CACB)相比的相对益处仍不明确。

方法

在我们的回顾性队列研究中,2016年1月至2023年12月期间接受单侧初次UKA的患者被分配到CACB组或SACB组。主要结局是疼痛视觉模拟量表(VAS)评分。次要结局包括额外的镇痛治疗、活动评分、术后恶心呕吐(PONV)、并发症及住院时间(LOS)。

结果

在根据年龄、性别、体重指数(BMI)和术前疼痛评分进行1:1倾向评分匹配后,每组纳入35例患者(SACB组和CACB组)。术后24小时,SACB组的VAS疼痛评分略高于CACB组,尽管这一差异无统计学意义。SACB组的麻醉后恢复室(PACU)活动评分显著更高(P = 0.02),与CACB组相比,LOS显著缩短约3天(P < 0.001)。两组在额外镇痛治疗、牛津膝关节评分(OKS)、PONV或并发症方面未发现显著差异。

讨论

与SACB相比,CACB在UKA术后三个月内并未显著减轻术后疼痛或改善功能结局。然而,SACB与术后即时活动能力改善和LOS缩短相关,提示对早期恢复有潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a8c/12325113/21cc8a5c1ef4/JPR-18-3851-g0001.jpg

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