MEDLINE/PubMed Journal Browser Search

Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

Title: [A prospective comparative study on effectiveness of single versus continuous adductor canal block combined with local infiltration anesthesia in unicompartmental knee arthroplasty].
Author: Liu D, Huang W, Zhai W, Li Y, Chen D, Zheng S, Wu Y, Lu W.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2024 Apr 15; 38(4):448-454. PubMed ID: 38632065.
Abstract:
OBJECTIVE: To compare the early analgesic effects and the impact on knee joint function recovery after unicompartmental knee arthroplasty (UKA) between single adductor canal block (SACB) and continuous adductor canal block (CACB) combined with local infiltration anesthesia (LIA) using a prospective study. METHODS: The patients with knee osteoarthritis admitted between April 2022 and December 2023 were enrolled as a subject. Among them, 60 patients met the selection criteria and were enrolled in the study. They were randomly assigned to the SACB group or CACB group in a ratio of 1:1 using a random number table method. There was no significant difference between the two groups ( P>0.05) in terms of age, gender, height, body mass, body mass index, affected side, and preoperative resting visual analogue scale (VAS) score and active VAS score, Oxford knee score (OKS), and American Hospital of Special Surgery (HSS) score. All patients received multimodal analgesia management using LIA combined with SACB or CACB. The operation time, pain related indicators (resting and activity VAS scores, number and timing of breakthrough pain, opioid consumption), joint function related indicators (quadriceps muscle strength, knee range of motion, OKS score, and HSS score), as well as postoperative block complications and adverse events were recorded and compared between the two groups. RESULTS: There was no significant difference in the operation time between the two groups ( P<0.05). All patients in the two groups were followed up with a follow-up time of (9.70±4.93) months in the SACB group and (12.23±5.05) months in the CACB group, and the difference was not significant ( P>0.05). The CACB group had a significant lower resting VAS score at 24 hours after operation compared to the SACB group ( P<0.05). There was no significant difference in resting and active VAS scores between the two groups at other time points ( P>0.05). The CACB group had a significantly lower incidence of breakthrough pain compared to the SACB group [9 cases (30.00%) vs. 17 cases (56.67%); P<0.05). However, there was no significant difference in the timing of breakthrough pain occurrence and opioid consumption between the two groups ( P>0.05). Four cases in the SACB group and 7 cases in the CACB group experienced adverse events, with no significant difference in the incidence of adverse events between the two groups ( P>0.05). The CACB group had significantly better knee joint mobility than the SACB group at 1 and 2 days after operation ( P<0.05). There was no significant difference between the two groups in knee joint mobility on 0 day after operation and quadriceps muscle strength and OKS and HSS scores at different time points ( P>0.05). CONCLUSION: In UKA, the analgesic effects and knee joint function recovery are similar when compared between LIA combined with SACB and LIA combined with CACB. However, SACB is simpler to perform and can avoid adverse events such as catheter displacement and dislocation. Therefore, SACB may be a better choice. 目的: 采用前瞻性对比研究，比较分析膝关节单髁置换术（unicompartmental knee arthroplasty，UKA）术中采用局部浸润麻醉（local infiltration anesthesia，LIA）联合单次收肌管阻滞（single adductor canal block，SACB）或连续收肌管阻滞（continuous adductor canal block，CACB）的早期镇痛效果及对膝关节功能恢复的影响。. 方法: 以2022年4月—2023年12月收治的膝关节骨关节炎患者作为研究对象，其中60例符合选择标准纳入研究，按照随机数字表法以1∶1比例分配至SACB组或CACB组。两组患者年龄、性别、身高、体质量、身体质量指数、手术侧别以及术前静息疼痛视觉模拟评分（VAS）、活动VAS评分、牛津大学膝关节评分（OKS）和美国特种外科医院（HSS）评分等基线资料比较，差异均无统计学意义（ P>0.05）。两组患者接受LIA联合SACB或CACB多模式镇痛管理。记录并比较两组手术时间、疼痛相关指标（静息以及活动VAS评分，发生突破性疼痛例数及时间，阿片类药物消耗量）、关节功能相关指标（股四头肌肌力、膝关节活动度、OKS评分和HSS评分）以及术后阻滞并发症、不良事件。. 结果: 两组手术时间差异无统计学意义（ P<0.05）。两组患者术后均获随访，SACB组随访时间为（9.70±4.93）个月、CACB组为（12.23±5.05）个月，差异无统计学意义（ P>0.05）。除CACB组术后24 h静息VAS评分低于SACB组，差异有统计学意义（ P<0.05）外，其余各时间点两组静息和活动VAS评分比较差异均无统计学意义（ P>0.05）。 CACB组9例（30.00%）发生突破性疼痛，较SACB组17例（56.67%）减少，发生率差异有统计学意义（ P<0.05）；但两组突破性疼痛发生时间和阿片类药物消耗量比较，差异均无统计学意义（ P>0.05）。SACB组4例、CACB组7例发生不良事件，发生率差异无统计学意义（ P>0.05）。CACB组术后1、2 d膝关节活动度优于SACB组（ P<0.05）；两组术后0 d膝关节活动度以及各时间点股四头肌肌力、OKS评分、HSS评分比较，差异均无统计学意义（ P>0.05）。. 结论: UKA术中LIA联合SACB或CACB镇痛效果以及患者膝关节功能恢复程度相似，但SACB具有操作简便，能避免导管移位、脱位等不良事件发生，可能是一种更好选择。.

[Abstract] [Full Text] [Related] [New Search]