组织工程与重建外科杂志 ›› 2023, Vol. 19 ›› Issue (1): 64-.

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超声引导下股神经阻滞联合腘动脉与膝关节后囊间隙(IPACK)阻滞在前交叉韧带重建术后镇痛中的应用效果

  

  • 出版日期:2023-02-01 发布日期:2023-03-08

Efficacy of ultrasound-guided femoral nerve block combined with infiltration between the popliteal artery and capsule of the posterior knee block (IPACK) in analgesia after anterior cruciate ligament reconstruction

  • Online:2023-02-01 Published:2023-03-08

摘要:

目的 探讨超声引导下股神经阻滞(FNB)联合腘动脉与膝关节后囊间隙(IPACK)阻滞在前交叉韧带重建术后镇痛中的应用效果。方法 选择 2021 年 1 月至 2022 年 3 月我院收治的 80 例拟行前交叉韧带重建手术患者,按随机数字表法将患者分为两组。对照组采用超声引导下 FNB,观察组采用超声引导下 FNB 联合 IPACK 阻滞。比较两组术后舒芬太尼用量、PCIA 按压次数、补救性镇痛比例、术后疼痛程度、膝关节活动度、下肢肌力、最长行走距离、首次下床活动时间以及不良反应等。结果 观察组术后舒芬太尼用量、PCIA 按压次数、补救性镇痛比例、首次下床活动时间均低于对照组(P<0.05)。两组术后静息、活动时 VAS 评分均逐渐降低(P<0.05),术后膝关节活动度、小腿三头肌肌力、股四头肌肌力、最长行走距离均逐渐增加(P<0.05),观察组术后 T0-4 活动时 VAS 评分低于对照组(P<0.05),膝关节活动度、最长行走距离大于对照组(P<0.05),两组静息时 VAS 评分、小腿三头肌肌力、股四头肌肌力比较差异无统计学意义(P>0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论 与 FNB 比较,超声引导下 FNB 联合 IPACK 在前交叉韧带重建术后具有满意的镇痛效果,利于术后早期康复锻炼。

关键词:

Abstract:

 Objective To investigate the efficacy of ultrasound-guided femoral nerve block (FNB) combined with infiltration
between the popliteal artery and capsule of the posterior knee block (IPACK) in analgesia after anterior cruciate ligament
reconstruction. Methods From January 2021 to March 2022, 80 patients undergoing anterior cruciate ligament reconstruction
were selected and divided into two groups by random number table method. The control group was treated with ultrasound-guided
FNB, and the observation group was treated with ultrasound-guided FNB combined with IPACK block. The dosage of sufentanil,
the number of PCIA compressions, the proportion of salvage analgesia, the degree of postoperative pain, the range of motion of
knee joint, the muscle strength of lower limb, the longest walking distance, the leaving bed time and the adverse reactions of the
two groups were compared. Results The dosage of sufentanil, times of PCIA pressing, proportion of salvage analgesia and the
leaving bed time in the observation group were all lower than those in the control group (P<0.05). Postoperative VAS scores at
rest and activity were gradually decreased in both groups (P<0.05), postoperative knee joint range of motion, triceps calf muscle
strength, quadriceps femoris muscle strength and the longest walking distance were gradually increased (P<0.05). VAS score of
T0-4 activity in the observation group was lower than that in the control group (P<0.05), the knee joint range of motion and longest
walking distance were higher than those in the control group (P<0.05). There were no statistically significant differences in VAS
score at rest, triceps muscle strength and quadriceps muscle strength between the two groups (P>0.05). There was no significant
作者单位 :236800 安徽省亳州市 亳州市人民医院麻醉科。? 65 ?
组织工程与重建外科 2023 年 2 月 第 19 卷第 1 期
difference in the incidence of complications between the two groups (P>0.05). Conclusion Compared with FNB, ultrasound
guided FNB combined with IPACK has a satisfactory analgesic effect after anterior cruciate ligament reconstruction, which is
conducive to early postoperative rehabilitation and exercise

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