Application of ultrasound-guided continuous saphenous nerve block combined with multimodal analgesia for rehabilitation after total knee arthroplasty
10.12089/jca.2018.04.002
- VernacularTitle:超声引导下连续隐神经阻滞联合多模式镇痛在膝关节置换术中的应用
- Author:
Qiuyue DONG
1
;
Xinyu YAO
;
Shuangtao CHEN
;
Qian SONG
;
Zhiliang CHEN
;
Yejing CHAI
Author Information
1. 冀中能源邢台矿业集团总医院麻醉科
- Keywords:
Arthroplasty,replacement,knee;
Saphenous nerve;
Femoral nerve;
Nerve block
- From:
The Journal of Clinical Anesthesiology
2018;34(4):322-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of continuous saphenous nerve block (SNB)with femoral nerve block (FNB)under multimodal analgesia for early analgesic effect and rehabilitation af-ter total knee replacement (TKA).Methods Sixty patients scheduled to undergo TKA,23 males and 37 females,were randomly divided into two groups:group A (continuous SNB)and group B (contin-uous FNB ).The patients received PCA after surgery by the catheter placed near nerve with ultrasound-guided.The loading dose was 0.5% ropivacaine 25 ml and 0.1 mg epinephrine,back-ground dose was 5 ml/h,bolus dose was 5 ml and the locking time was 20 min.The first time to walk and total steps,the knee joint range of motion,postoperative hospital stay,general anesthetics and additional analgesics dose and the side effects were also recorded.Results The first time to walkand walking distancein group A were better than group B [(25.4±2.1)h vs (34.0±2.7)h,(7.6±1.8) steps vs (3.7±1.3)steps,(P<0.05)].The range of motion in group A was bigger than in group B [12 h:(75.8±4.3)°vs (65.4±4.7)°,24 h:(93.3±4.2)°vs (81.8±4.3)°,48 h:(102.1±4.1)° vs (95.1±2.6)°,P<0.05].The average length of postoperative hospital stay was shorter in group A than in group B [(5.3±1.2)d vs (7.4±1.4)d,P<0.05].The additional analgesics and the side effects were similar between the two groups.Conclusion The continuous SNB combined with multi-modal analgesia was more beneficial to patients with the early postoperative rehabilitation for TKA.
