在全膝关节整形术后进行术后止痛的三次注射周围 (TIPS) 阻断:随机对照研究
Ahmad Samir Alabd1, Moustafa Abdelaziz Moustafa1, Aly Mahmoud Moustafa Ahmed1
1Faculty of Medicine, Alexandria University, Egypt.
Indian journal of anaesthesia
|March 13, 2024
概括
三次注射周围萨尔托里乌斯 (TIPS) 阻断提供优越的疼痛缓解和膝关节整形术 (TKA) 后更快的恢复,与股骨神经阻断 (FNB) 相比. TIPS 阻断减少了吗啡的消耗,改善了行走和膝盖延伸,同时节省了运动功能.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
背景情况:
- 有效的术后止痛对于在全膝关节整形术 (TKA) 后的患者康复至关重要.
- 在不损害运动功能的情况下实现疼痛缓解是TKA疼痛管理的关键目标.
- 三次注射周围沙体 (TIPS) 阻断是一种用于TKA止痛的新方法.
研究的目的:
- 为了比较TIPS阻断与大腿神经阻断 (FNB) 在TKA后运动节约性止痛的疗效.
- 为了评估术后疼痛得分,吗啡消耗,行走和TKA后膝盖延伸.
主要方法:
- 接受TKA的80名患者被随机分配,在手术切口前接受超声导向的TIPS阻塞或超声导向的FNB.
- TIPS的阻断涉及注射布皮瓦卡因和德克萨米他松在Sartorius肌肉周围的特定位置.
- 术后疼痛使用视觉模拟量表 (VAS) 进行评估,并测量了吗啡摄入量,行走距离和活跃的膝盖延伸.
主要成果:
- 与FNB组相比,接受TIPS块的患者报告动态VAS得分明显较低.
- 在手术后,TIPS组消耗的吗啡显著减少 (5.82毫克对比9.87毫克).
- TIPS组在行走距离 (18.0m vs. 8.95m) 和活动膝盖延伸 (52.12° vs. 26.05°) 方面表现出了卓越的改善. 在TIPS组中,恶心的频率也较低.
结论:
- 与TKA后的FNB相比,TIPS块提供了优异的术后止痛.
- TIPS 块有助于更好地保护运动功能,从而改善行走和膝盖移动性.
- 这种技术提供了一种有希望的替代方案,以改善膝关节全关节整形术后的恢复.
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