超声引导下收肌管联合ipAck神经阻滞在膝关节置换术后镇痛中的应用研究精品.pdf

JModMedHealth,May2021,Vol.37,No.9・1465・•论著•超声引导下收肌管联合神经阻滞在ipAck膝关节置换术后镇痛中的应用研究*刘宇权，乌卩文伟，王军，曾志文，廖亿舞（梅州市人民医院麻醉科，广东梅州514031）［摘要］目的探讨超'引导下收肌管联合ipAck神经阻滞用于膝关节置换术后镇痛的临床效果$方法选取该院2018年2月至2019年12月该院收治的行膝关节置换术患者90例，随机分为对照组（45例）和观察组（45例），分别采用超'引导下收肌管阻滞和超'引导下收肌管联合ipAck神经阻滞方案行术后镇痛$比较两组术后48h疼痛数字评分法11（NRS）静态/动态评分曲线下面积（AUC）、麻醉药物使用情况［舒芬太尼使用量、静脉自控镇痛泵（PCIA）按压率）下床最多活动步数及主动屈膝最大角度$结果观察组术后48hNRS静态/动态评分AUC均显著低于对照组；舒芬太尼用量显著少于对照组，差异均有统计学意义（P<0.05）两组PCIA按压率比较，差异无统计学意义（P>0.05）观察组术后48h下床最多活动数和步主动屈膝最大角度均显著多于对照组，差异均有统计学意义（P<0.05）结论超'引导下收肌管联合ipAck神经阻滞用于膝关节置换术后镇痛可有效缓解患者术后疼痛程度，减少麻醉药物用量，并有助于改善患者早期活动功能$［关键词］超'&收肌管阻滞；ipAck神经阻滞；膝关节置换术；镇痛DOI：10.3969/j.issn.1009-5519.202109.008中图法分类号：R614.3；R614.4文章编号:1009-5519（2021）09-1465-03文献标识码:AStudyontheapplicationofadductortubecombinedwithipAcknerveblockunderultrasoundguidanceinanalgesiaafterknee*arthroplastyLIUYuquan,WUWenzvei,WANGJunZENGZhixvenLIAOYiling(.DepartmentofAnesthesiology^MeizhouPeople'Hospital■,Meizhou,Guangdong514031China')[Abstract]ObjectiveToexploretheclinicaleffectofadductortubecombinedwithipAcknerveblockunderultrasoundguid­anceinanalgesiaafterkneearthroplasty.MethodsAtotalof90patientsundergoingkneearthroplastyinthehospitalfromFebru­ary2018toDecember2019wereselectedandrandomlydividedintocontrolgroup(45cases)andobservationgroup(45cases).AdduGtortubebloGkunderultrasoundguidanGeandadduGtortubeGombinedwithipAGknervebloGkultrasound-guidedwereadopt-edforpostoperativeanalgesiarespectively.TheAreaunderthecurve(AUC)ofstatic/dynamicscoreofnumericalpainscore11(NRS),theuseofanesthetics[theusageofsufentanil,thecompressionrateofintravenouspatient-controlledanalgesiapump(PI­CA)],themaximumnumberofstepstogetoutofbed,andthemaximumangleofactivekneeflexionat48hoursaftertheopera­tionwerecomparedbetweenthetwogroups.ResultsTheAUCofstatic/dynamicscoreofNRSat48hafteroperationintheob­servationgroupwassignificantlylowerthanthatinthecontrolgroup；thedosageofsufentanilintheobservationgroupwassignifi­cantlylessthanthatinthecontrolgroup,andthedifferenceswerestatisticallysignific