连续股神经阻滞复合西乐葆对全膝关节置换围术期镇痛效果观察.docVIP

连续股神经阻滞复合西乐葆对全膝关节置换围术期镇痛效果观察 　　[摘要] 目的 探讨连续股神经阻滞镇痛（CFNB）复合西乐葆与静脉镇痛（CIA）对全膝关节置换术患者术后镇痛效果的影响。 方法 选择我院2008年6月~2010年12月ASAⅠ~Ⅱ级行单侧膝关节置换术患者305例作为观察对象，根据术后采用的镇痛方式的不同分为CFNB复合西乐葆组（A组）122例与CIA组（B组）183例，观察并记录两组术后24、48 h的疼痛评分及使用其他止痛药的剂量、次数和不良反应。 结果 术后24、48 h时A组中、重度疼痛患者比例明显低于B组（P 　　[关键词] 全膝关节置换术；股神经；西乐葆；围术期镇痛 　　[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210（2012）02（c）-0046-03 　　 　　Observation of perioperative analgesic effects of continuous femoral nerve block combined with Celebrex on total knee replacement 　　QIAO Tianzhu1 TENG Jiasong1 WANG Dong1 LI Na1 WANG Mingxia1 LI Jun2 MA Ling2 　　1.The First Department of Orthopedics, Daqing Oilfield General Hospital, Heilongjiang Province, Daqing 163001, China;2.Department of Anesthesiology, Daqing Oilfield General Hospital, Heilongjiang Province, Daqing 163001, China 　　[Abstract] Objective To investigate the impact of continuous femoral nerve block (CFNB) combined with Celebrex and controlled intravenous analgesia (CIA) on the postoperative analgesic effects of total knee replacement. Methods 305 patients of ASA I-II who had received unilateral knee replacement in our hospital from June 2008 to December 2010 were divided into the CFNB combined with celebrex group (group A) with 122 patients and the CIA group (group B) with 183 patients. The pain scores and the dosage, times and adverse reactions of the two groups with 24 and 48 hours after surgery were observed and recorded. Results 24 and 48 hours after surgery, group A was significantly lower than group B in the ratios of patients with moderate and severe pain (P 　　1 资料与方法 　　1.1一般资料 　　 选择我院2008年6月~2010年12月行单侧膝关节置换术患者共305例作为观察对象，其中，男133例，女172例，纳入标准为既往无患肢骨折病史，首次置换，无风湿类风湿病史。全部入选患者的年龄为65~79岁，平均73.5岁；体重57~88 kg，平均69.3 kg。所有患者在硬膜外腰麻联合麻醉下行单侧膝关节置换术。患者自主选择术后镇痛方式，其中CFNB复合口服西乐葆组122例设立为A组，CIA组183例，设立为B组。两组入选患者的年龄、性别、性别构成比、体重等临床基础资料比较，差异无统计学意义（P ＞0.05），具有可比性。两组患者一般资料比较见表1。 　　 　　表1 两组患者一般资料比较（x±s） 　　 　　 　　 　　 　　 　　 　　 　　1.2 镇痛方法 　　1.2.1 A组 患者术前晨口服西乐葆100 mg，手术结束后行股神经置管