摘要
目的 :观察连续腰大肌间沟阻滞用于全膝关节置换术后镇痛的疗效 ,并与硬膜外镇痛进行对比研究。方法 :选择ASAⅠ～Ⅱ级行全膝关节置换手术病人 2 0例 ,随机分为 2组 ,EA组 :硬膜外术后镇痛 ,采用 0 .12 5 %罗吡卡因 +芬太尼 2 μg/ml,5ml/小时 ;PA组 :腰丛神经阻滞术后镇痛 ,采用 0 .12 5 %罗吡卡因 ,5ml/小时 ,两组维持镇痛 3～ 5天。记录静息和持续被动运动时的VAS疼痛评分 ,肌力分级 ,镇静程度和并发症发生率。结果 :在术后 12小时 ,2 4小时患膝持续被动活动(CPM ) ,4 8小时 (CPM )时PA组VAS评分明显小于EA组 ;肌力分级在术后 12小时和 2 4小时PA组高于EA组 ;PA组无并发症发生 ,EA组术后恶心发生率明显高于PA组 ;两组病人镇静程度无差异。结论 :腰大肌间沟阻滞用于全膝关节置换术后镇痛较之硬膜外镇痛明显减轻静息和运动时的疼痛 ,减少并发症发生 ,对下肢肌力影响更小 ,因此是一种令人满意的术后镇痛方法。
Objective:To determine the effects of continuous lumbar plexus block on postoperative pain after total knee replacement (TKR) surgery, and compare with the effects of epidural block. Methods: Twenty adult patients, ASA I II, undergoing TKR surgery, were randomly divided into two groups: group PA and EA. Group EA received epidural postoperative analgesia with 0.125% Ropivacaine + Fentanyl 2μg/ml, at 5ml/h; group PA received lumbar plexus block analgesia after operation with 0.125% Ropivacaine at 5ml/h. All of them maintained analgesia for 3～5 days. VAS Pain scores at rest and during continuous passive motion, muscle strength grades, Rameasay sedation scores and complications were assessed and recorded. Results:The VAS pain scores of PA group at 12h, 24h (continuous passive movement CPM), and 48h(CPM) were lower; muscle strength grades were higher at 12h and 24h than that of EA group. There was no differences of sedation scores in both groups . No complication was found in PA group, while nausea was revealed in EA group. Conclusion: The continuous lumbar plexus block for postoperative analgesia in TKR surgery reduces pain scores both in rest and in movement, with reduction of the incidence of complication and a relative increase of muscle strength. Thereby it is a satisfactory choice for the treatment of post operative pain in major knee surgery.
出处
《中国疼痛医学杂志》
CAS
CSCD
2002年第3期149-151,154,共4页
Chinese Journal of Pain Medicine
