摘要目的 观察神经刺激仪引导下连续股神经阻滞用于膝关节术后镇痛的效果。方法 选取2017年2～12月我院行下肢术后镇痛患者100例，按照随机数字表法分为参照组和观察组，每组各50例。参照组实施连续静脉给药镇痛，观察组实施神经刺激仪引导下连续股神经阻滞镇痛，比较两组患者的各项临床指标、VAS评分、Ramsay镇静评分及不良反应发生率。结果 两组的HR和SpO2比较，差异无统计学意义（P＞0.05），参照组的SBP、DBP高于观察组，差异有统计学意义（P<0.05）；两组治疗前VAS评分比较，差异无统计学意义（P＞0.05），观察组治疗6、12、36及48 h VAS评分低于参照组，差异有统计学意义（P<0.05），观察组治疗前后VAS评分比较，差异无统计学意义（P＞0.05），参照组治疗后各时间段VAS评分高于治疗前，差异有统计学意义（P<0.05）；两组治疗前Ramsay镇静评分比较，差异无统计学意义（P＞0.05），观察组治疗6、12、36及48 h Ramsay镇静评分低于参照组，差异有统计学意义（P＜0.05），且观察组和参照组治疗后各时间段Ramsay镇静评分高于治疗前，差异有统计学意义（P＜0.05）；观察组不良反应发生率低于参照组，差异有统计学意义（P＜0.05）。结论 神经刺激仪引导下连续股神经阻滞用于膝关节术后镇痛的效果较好，具有安全性和有效性，可在临床实践中予以广泛推广和应用。
Abstract：Objective To observe the effect of continuous femoral nerve block guided by nerve stimulators for postoperative analgesia in knee joints.Methods A total of 100 patients performed with postoperative analgesia for the lower extremities from February to December in 2017 were selected.They were equally divided into two groups by a random number table method,50 cases in each group.In the reference group,continuous intravenous analgesia was used,while in the observation group,continuous femoral nerve block guided by nerve stimulator was adopted.The clinical indicators,visual analogue scale (VAS),Ramsay sedation score,and incidence of adverse reactions in the two groups were compared.Results There was no significant difference in heart rate(HR)or oxyhemoglobin saturation(SpO2)between the two groups(P＞0.05）.The systolic blood pressure (SBP)and diastolic blood pressure (DBP)were higher in the reference group than in the observation group and the difference was statistically significant(P＜0.05）.The VAS scores before treatment in both groups were not displayed statistical significance between the two groups (P＞0.05）.The VASscores 6,12,36 and 48 h after treatment in the observation group were all lower than those in the reference group and the difference was statistically significant(P＜0.05）.There was no significant difference in VAS scores before and after treatment in the observation group(P＞0.05）.The scores of the reference group at different timepoints after treatment were all higher compared with those before treatment and the difference was statistically significant(P＜0.05）.Ramsay sedation scores before treatment in both groups were not displayed statistical significance (P＞0.05）.The Ramsay sedation scores 6,12,36 and 48 h after treatment in the observation group were all lower than those in the reference group and the difference was statistically significant(P＜0.05）.What′s more,the Ramsay sedation scores at different timepoints after treatment in the two groups were higher compared with those before treatment and the difference was statistically significant(P＜0.05）.The incidence of adverse reactions in the observation group was lower than that in the reference group,and the difference was statistically significant(P＜0.05）.Conclusion The continuous femoral nerve block guided by nerve stimulator is effective for postoperative analgesia of knee joint.It is safe and can be widely used and promoted in clinical practice.
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