《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (12): 1176-1177.

• 论文 • 上一篇    下一篇

股神经阻滞在膝关节松解术后康复治疗中的镇痛作用

任自刚1,2a，王强1,2a，王增春1,2a，刘海泉1,2a，刘克敏1,2b   

  1. 1.首都医科大学康复医学院，北京市 100068；2.中国康复研究中心北京博爱医院，a: 麻醉科;b: 骨科，北京市 100068。
  • 收稿日期:2010-11-10 修回日期:1900-01-01 出版日期:2010-12-25 发布日期:2010-12-25

Analgesia of Femoral Nerve Block on Knee Stiffness in Rehabilitation Training after Surgery

REN Zi-gang, WANG Qiang, WANG Zeng-chun,et al   

  1. Capital Medical University School of Rehabilitation Medicine, Department of Anesthesiology, Beijing Charity Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Received:2010-11-10 Revised:1900-01-01 Published:2010-12-25 Online:2010-12-25

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摘要： 目的比较股神经阻滞和硬膜外阻滞对膝关节松解术后康复治疗的影响。方法选择行单侧膝关节松解术患者60例抽签法随机分为A组和B组，A组40例，B组20例。A组行股神经留置导管，B组行硬膜外留置导管。术后12 h、24 h、36 h、48 h，行被动运动康复治疗，然后行主动运动康复治疗。在治疗前留置导管中注射2％利多卡因进行阻滞。被动运动康复治疗结束后让患者对治疗中疼痛进行VAS评分，并记录从被动运动康复治疗结束到进行主动运动康复治疗所需要的时间。比较两组副作用(低血压、恶心)的发生率。结果两组在被动运动康复治疗后VAS评分无显著性差异。A组从被动运动康复治疗结束到进行主动运动康复治疗所需要的时间明显少于B组。A组副作用发生率低于B组。结论股神经阻滞在膝关节松解术后镇痛效果明确，可以更早地进行主动运动康复治疗，副作用少，安全性高，是膝关节松解术后康复治疗较为理想的镇痛方法。

关键词: 股神经阻滞, 硬膜外阻滞, 膝关节松解术, 被动运动康复治疗, 主动运动康复治疗

Abstract: ObjectiveTo compare the effect of rehabilitation training after surgical intervention of knee stiffness (SIKS) between femoral nerve block (FNB) and epidural nerve block (ENB).Methods60 patients undergoing SIKS at one knee joint were randomly assigned to two groups: 40 patients accepting a catheter for FNB in group A and 20 patients accepting a catheter for ENB in group B. All patients participated in passive rehabilitation therapy (PRT) and active rehabilitation therapy (ART) at 12 hours, 24 hours, 36 hours, and 48 hours after operation. 10 ml of lidocaine were applied via these catheters before rehabilitation therapy. The visual analogue score (VAS) for pain in PRT, the time needed from the end of PRT to the start of ART, and the incidence of side effects such as hypotension or nausea were recorded.ResultsThere was no significant difference in VAS between groups A and B. The time needed from the end of PRT to the start of ART in group A was significantly less than that of group B. The incidence of hypotension or nausea in group A was significantly less than those of group B.ConclusionFNB provides the same analgesic effect as ENB, has less time needed from the end of PRT to the start of ART, and lowers incidence of hypotension or nausea.

Key words: femoral nerve block, epidural nerve block, surgical intervention of knee stiffness, passive rehabilitation therapy, active rehabilitation therapy