河北医科大学学报 ›› 2024, Vol. 44 ›› Issue (5): 555-559.doi: 10.3969/j.issn.1007-3205.2024.05.011

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超声PENG阻滞在老年患者TKA中的应用价值及对术后舒适度的影响

  

  1. 1.江苏省南通市中医院麻醉科,江苏 南通  226001;2.南通大学附属医院麻醉科,江苏 南通  226001

  • 出版日期:2024-05-25 发布日期:2024-05-22
  • 作者简介:黄丽(1980-),女,江苏南通人,江苏省南通市中医院副主任医师,医学硕士,从事临床麻醉学研究。
  • 基金资助:
    江苏省自然科学基金资助项目(SBK2020041671)

The application value of ultrasound-guided PENG block in elderly patients with TKA and its impact on postoperative comfort

  1. 1.Department of Anesthesiology, Nantong Hospital of Traditional Chinese Medicine, Jiangsu Province, 
    Nantong 226001, China; 2.Department of Anesthesiology, the Affiliated Hospital of 
    Nantong University,  Jiangsu Province, Nantong 226001, China

  • Online:2024-05-25 Published:2024-05-22

摘要: 目的 探讨超声引导下髋关节囊周围神经(ultrasound-guided pericapsular nerve block,PENG)阻滞在老年全膝关节置换术(total knee arthroplasty,TKA)中的应用效果。
方法 选取在江苏省南通市中医院和南通大学附属医院治疗的TKA患者120例,采用信封法将患者分为观察组(n=60)和对照组(n=60),观察组给予超声引导下PENG阻滞复合全身麻醉,对照组给予全身麻醉,观察2组麻醉效果等。
结果 观察组和对照组手术时间、术中出血量和麻醉时间比较差异无统计学意义(P>0.05);2组平均动脉压(mean arterial pressure ,MAP)、收缩压(systolic pressure,SBP)、舒张压(diastolic pressure,DBP)、心率( heart rate,HR)在时点间与组间·时点间交互作用方面比较差异有统计学意义(P<0.05),在组间比较差异无统计学意义(P>0.05)。2组血氧饱和度(blood oxygen saturation,SpO2)在组间、时点间、组间·时点间方面差异均无统计学意义(P>0.05)。2组疼痛VAS评分、舒适度视觉模拟(visual analogue scores,VAS)评分在组间、时点间、组间·时点间交互作用方面比较差异有统计学意义(P<0.05)。观察组心动过缓和低血压发生率为0.00%和1.67%,明显低于对照组(P<0.05)。
结论 超声引导下PENG阻滞在老年TKA中有较好的应用效果,具有术后疼痛轻、舒适度好等优点。


关键词: 关节成形术, 置换, 膝, 超声引导, 老年人

Abstract: Objective To investigate the application effect of ultrasound-guided pericapsular nerve group (PENG) block in elderly patients undergoing total knee arthroplasty (TKA). 
Methods A total of 120 patients with TKA who were treated in our hospital and the Affiliated Hospital of Nantong University were selected and divided into the observation group (n=60) and the control group (n=60) by envelope method. The observation group was given ultrasound-guided PENG block and general anesthesia, and the control group was given general anesthesia, to observe the anesthesia effects of the two groups. 
Results There was no significant difference between the observation group and the control group with respect to duration of operation, intraoperative bleeding and anesthesia time (P>0.05). There was a significant difference in the interaction between time points and time points between groups in terms of mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) between the two groups (P<0.05), while there was no significant difference between groups (P>0.05). There was no significant difference in interaction between groups, time points and time points between groups with respect to blood oxygen saturation (SpO2) (P>0.05). There was a significant difference in interaction between groups, time points and time points between groups in terms of visual analogue scale (VAS) score for pain and comfort. 
Conclusion Ultrasound-guided PENG block has a good application effect in elderly TKA, with the advantages of less postoperative pain, and good comfort. 


Key words: arthroplasty, replacement, knee, ultrasound guidance, elderly