在关节镜膝关节手术中,对神经神经块和高体积近接导管道块之间进行术后疼痛管理的比较
Ali Khatibi1, Mahmood-Reza Alebouyeh2, Maryam Aavin Salahian3
1Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Anesthesiology and pain medicine
|February 27, 2026
概括
高容量近接附加管道阻塞 (HI-PAC) 和神经阻塞在前十字带重建后治疗术后疼痛方面同样有效. 这两种技术都显著降低了疼痛强度和阿片类药物消耗,在有效性上没有显著差异.
科学领域:
- 麻醉学和疼痛管理
- 整形外科手术 整形外科手术
- 区域麻醉技术 区域麻醉技术
背景情况:
- 在下肢手术后,严重的术后疼痛是常见的,可能导致严重的并发症.
- 有效的疼痛管理至关重要,局部麻醉技术,如高容量近接道阻塞 (HI-PAC) 提供了一个可行的解决方案.
- HI-PAC的目标是大腿神经,间接地是大腿中部偏远部的坐骨神经.
研究的目的:
- 为了比较超声导向高体积近接附加管道阻塞 (HI-PAC) 与神经阻塞在术后疼痛管理中的疗效.
- 评估前十字带 (ACL) 重建的患者的疼痛强度,止痛效果和动荡水平.
主要方法:
- 这是一项双盲研究,涉及50名接受ACL重建的患者 (30-70岁,ASA身体状况I/II).
- 患者接受全身麻醉,病例组接受HI-PAC (0.1%罗皮瓦卡因,30毫升),对照组接受沙芬神经阻塞 (0.2%罗皮瓦卡因,15毫升).
- 疼痛 (数值评分表) 和激动 (兰赛镇静评分) 在阻断后的多个时间点进行了评估.
主要成果:
- 这两组在阻塞后12小时内都显示出疼痛强度的显著下降.
- 在0.5,2,4,6和12小时的平均数值评分表得分在HI-PAC组 (4.01) 和沙神经阻断组 (4.18) 之间是可比的.
- 两种神经阻断技术的平均阿片类药物消耗和兴奋水平在两种神经阻断技术之间相似.
结论:
- 高体积的近接附加管道阻塞和软神经阻塞在减少ACL重建后的急性术后疼痛方面同样有效.
- 在这项研究中,神经阻塞技术的选择并没有显著影响疼痛的严重程度.
- 多变量分析证实了两种区域麻醉技术在疼痛管理中的可比效果.
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