ABSTRACT
Objective:To analyze the application effects of ultrasound-guided fascia illiaca compartment block (FICB) and continuous adductor canal block (CACB) on analgesia after knee arthroplasty.Methods:84 patients undergoing total knee arthroplasty (TKA) in Department of Anesthesiology, Orthopaedic Hospital of Sichuan, from May 2016 to April 2018 were randomly divided into observation group and control group, 42 cases in each group. The observation group was given ultrasound-guided FICB. The control group was given ultrasound-guided CACB. The postoperative analgesia effects [visual analogue scale (VAS) in rest and exercise states], major neurosensory block rate, stress response (cortisol, glucose level), muscle strength of quadriceps femoris and complications in the two groups were compared.Results:There was no significant difference in VAS scores at rest stage between the two groups at any time point after operation ( P>0.05). The VAS scores at exercise state of the observation group were lower than those of the control group at 12 h, 24 h and 48 h after operation ( P<0.01). The block rate of lateral femoral cutaneous nerve in the observation group was higher than that in the control group at 5 min, 10 min, and 30 min after block ( P<0.01). There was no significant difference in the block rates of femoral nerves between the two groups at each above time point ( P>0.05). The levels of blood cortisol and blood glucose in the observation group were significantly lower than those in the control group at 24 h and 48 h after operation ( P<0.05). The muscle strength of quadriceps femoris in the observation group was lower than that in the control group at 24 h and 48 h after operation ( P<0.01). There was no significant difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Both FICB and CACB can significantly improve resting pain and femoral nerves in patients after total knee arthroplasty. FICB has advantages in blocking lateral femoral cutaneous nerve, controlling postoperative exercise pain and reducing stress response, while CACB has better effects on improving muscle strength of quadriceps femoris. The safety of the two groups is comparable. And each has its own advantages and disadvantages.
ABSTRACT
Objective:To compare the anesthetic effects and complications of different concentrations ropivacaine inultrasound-guided axillary brachial plexus block.Methods:From September 2016 to May 2018, 120 patients who underwent forearm or hand surgery in Sichuan Orthopedic hospital were selected as the study objects. According to the principle of random number table, the patients were divided into low-dose group ( n=40), medium dose group ( n=40) and high-dose group ( n=40). Different doses (0.25, 0.5, 0.75 ml/kg respectively) of 0.33% ropivacaine was used for local anesthesia. The anesthesia effect, complication rate, serum cardiac troponin I (cTnI) and creatine kinase myoglobin (CKMB) level and vital signs were compared among the three groups. Results:The onset time of sensory block and motor block in high dose group was shorter than that in low dose group and medium dose group, and the duration was longer than that in low dose group and medium dose group ( P<0.05); there was no significant difference in diastolic blood pressure (DBP), systolic blood pressure (SBP) and heart rate (HR) levels between the three groups at T 0 and T 3 ( P>0.05), and the DBP, SBP and HR levels in the three groups at T 1 were significantly lower than those at T 0 ( P<0.05); the level of DBP, SBP and HR in the low dose group was significantly higher than that in the medium dose group and the high dose group ( P<0.05), and there was no significant difference between the medium dose group and the high dose group ( P>0.05); the overall complication rate in the low dose group was 5.0%, which was significantly lower than that in the medium dose group (20.0%) and the high dose group (25.0%) ( P<0.05); after administration, the serum cTnI and CKMB levels in the low dose group were lower than those in the high dose group and medium dose group ( P<0.05). Conclusions:Three doses of ropivacaine can meet the surgical needs, but low-dose ropivacaine has a stable effect on vital signs and high safety.