满意的术后管理关节镜与小局部环囊神经群块:一个单中心,双盲,随机对照试验
Chong Zhang1, Yixin Fan2, Peiyu Li3
1Department of Anesthesia, Sichuan Provincial Orthopedic Hospital (Chengdu Sports Hospital and Chengdu Research Institute for Sports Injury), Chengdu, China. 1019403593@qq.com.
Trials
|December 26, 2025
概括
关节镜术的低体积周囊神经群 (PENG) 阻塞可以保持四头肌的强度,并提高恢复质量,而不是标准阻塞. 这些发现为患者提供了更好的疼痛管理和功能结果.
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:
- 目前的关节透镜止痛包括带 iliaca 隔间堵塞 (FICB) 和关节外围神经堵塞.
- 周围神经阻塞可以减少运动障碍,但仍会导致≥25%的患者出现虚弱.
- 对关节外围神经阻塞的低体积局部麻醉剂进行调查,以减少四头肌疲软,同时保持疼痛控制至关重要.
研究的目的:
- 评估低体积周囊神经群 (PENG) 阻塞在关节透术后维护术后四头肌强度方面的有效性.
- 为了比较FICB和PENG块之间的疼痛控制和恢复质量,使用不同的局部麻醉体积.
- 为了确定PENG阻塞中降低麻醉剂体积是否会影响四头骨功能和患者的结果.
主要方法:
- 一项随机试验涉及90名接受关节透视术的患者.
- 三组接受了FICB,PENG块与20毫升局部麻醉剂,或PENG块与10毫升局部麻醉剂.
- 主要结局是术后四头肌肌肉强度;次要结局包括疼痛评分,阿片类药物消耗和恢复质量.
主要成果:
- 两组之间没有观察到疼痛评分 (手术后2小时和1天) 或手术内应激反应的显著差异.
- 在术后2小时的四头肌强度中发现了显著的差异,有利于PENG 10毫升组.
- 与FICB相比,PENG 10毫升组显示了恢复质量的统计显著改善.
结论:
- 两种FICB和PENG块 (10毫升和20毫升) 在关节镜术中提供了可比的止痛和手术内应激反应.
- 低体积的PENG块 (10毫升) 显著增强术后四头肌肌肉强度的保存.
- 虽然PENG阻断可以提高恢复质量,但其大小可能无法达到临床上重要的最小差异,因此需要进一步调查.
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