在全膝关节整形术后进行术后止痛的双相对单次子关节块的比较分析 - 一个随机的双盲研究
Devyani Desai1, Neha Shah1, Kanchan Choube1
1Department of Anaesthesiology, Baroda Medical College, Vadodara, Gujarat, India.
Journal of anaesthesiology, clinical pharmacology
|July 10, 2025
概括
双子-sartorial区块 (DSB) 提供优越的缓解疼痛和更快的恢复后,全膝关节整形术 (TKA) 相比单子-sartorial区块 (SSB). DSB提供更持久的止痛,没有运动弱点,改善患者手术后的移动性.
科学领域:
- 麻醉学和疼痛管理
- 整形外科手术 整形外科手术
背景情况:
- 全膝关节整形 (TKA) 需要有效的术后疼痛管理.
- 目前的止痛技术包括单次亚沙托里亚区块 (SSB).
- 拟议的双子-sartorial区块 (DSB) 是为了覆盖更多的疼痛生成器.
研究的目的:
- 为了比较DSB与SSB在单方面TKA后的止痛效果.
- 评估DSB和SSB对TKA后运动强度保护的影响.
- 评估二次结果,包括行走和患者满意度.
主要方法:
- 一项随机研究,涉及60名接受单边TKA的患者.
- 患者被分配到手术后接受DSB (远三角块+近接道块) 或SSB (近接道块).
- 疼痛强度 (VAS),止痛的持续时间,救援止痛需求,定时启动和启动测试,并发症在24小时内被评估.
主要成果:
- DSB组的静态和动态VAS得分明显较低 (P < 0.001).
- DSB提供了更长的止痛时间 (14.96 ± 5.05小时 vs 6.03 ± 1.73小时,P < 0.0001).
- DSB需要更少的救援止痛药 (1.06 ± 0.37 vs 2 ± 0.52,P < 0.0001) 和改进的时间和时间测试时间 (53.48 ± 4.06s vs 66.16 ± 6.23s,P < 0.0001).
结论:
- 与TKA后的SSB相比,DSB提供了更好的疼痛控制和更长的止痛时间.
- DSB促进了较早的行走,并且不会导致运动软弱.
- 对于TKA患者来说,DSB是一种潜在的有利止痛技术.
相关概念视频
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
594
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
594
Local Anesthetics: Clinical Application as Spinal Anesthesia
807
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
807
Analgesia and Pain Management
816
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
816
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.2K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.2K


