دورية أكاديمية
[Research progress on analgesic effect of adductor canal block after knee arthroplasty].
| العنوان: | [Research progress on analgesic effect of adductor canal block after knee arthroplasty]. |
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| المؤلفون: | Liu D; Department of Joint Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510120, P. R. China., Wen X; Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510120, P. R. China., Lu W; Department of Joint Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510120, P. R. China. |
| المصدر: | Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery [Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi] 2023 Jan 15; Vol. 37 (1), pp. 106-114. |
| نوع المنشور: | English Abstract; Journal Article |
| اللغة: | Chinese |
| بيانات الدورية: | Publisher: Hua xi yi ke da xue Fu shu di 1 yi yuan Country of Publication: China NLM ID: 9425194 Publication Model: Print Cited Medium: Print ISSN: 1002-1892 (Print) Linking ISSN: 10021892 NLM ISO Abbreviation: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Chengdu Shi : Hua xi yi ke da xue Fu shu di 1 yi yuan Original Publication: Chengdu Shi : Hua xi yi ke da xue Fu shu di 1 yi yuan, |
| مواضيع طبية MeSH: | Arthroplasty, Replacement, Knee*/methods , Dexmedetomidine*/pharmacology , Nerve Block*/methods, Humans ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control ; Femoral Nerve ; Analgesics, Opioid/pharmacology |
| مستخلص: | Objective: To summarize the research progress of the analgesic effect of adductor canal block (ACB) applied to knee arthroplasty, in order to find the ACB mode that can obtain better effectiveness. Methods: The research progress of the analgesic effect of ACB after knee arthroplasty was reviewed by widely consulting the related literature on ACB at home and abroad in recent years. Results: In recent years, multimodal analgesia has become the mainstay of postoperative pain management after knee arthroplasty. Among these, ACB replaces the once "gold standard" femoral nerve block (FNB) by offering comparable and effective analgesia with better preservation of quadriceps function. It is generally safe and efficient to use 0.2% ropivacaine ACB with initial loading doses of 15-30 mL and continual loading doses of less than 8 mL/hour to give analgesia comparable to FNB with minimal impact on lower extremity muscular strength. However, the risk of patient falls must still be taken into consideration by medical staff. Adjuvants like dexmedetomidine and dexamethasone used in ACB can increase the analgesic duration and postoperative analgesic impact. As a perineural adjunct for ACB, 1 µg/kg dexmedetomidine may strike a balance between safety and analgesic efficacy. Conclusion: ACB is a safe and effective analgesia method after knee arthroplasty. The adductor canal anatomy, the optimum blocking strategy and blocking site of ACB are all hotly debated and still require additional study due to the significant variety of the nerve structures in adductor canal. |
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| فهرسة مساهمة: | Keywords: Knee arthroplasty; adductor canal block; analgesia; quadriceps muscle Local Abstract: [Publisher, Chinese] 总结收肌管阻滞（adductor canal block，ACB）应用于膝关节置换术后镇痛效果的研究进展，以期发现获得更好临床效果的ACB方式。. [Publisher, Chinese] 广泛查阅近年来国内外关于ACB的相关文献，对ACB应用于膝关节置换术后镇痛效果的研究进展进行综述。. [Publisher, Chinese] 近年来，多模式镇痛已成为膝关节置换术后疼痛管理的主要方法，其中ACB能够提供等效、良好的镇痛效果，同时更好地保存股四头肌功能，替代了“金标准”股神经阻滞（femoral nerve block，FNB）。在临床操作中使用0.2%罗哌卡因行ACB，首次负荷剂量为15～30 mL，持续负荷剂量<8 mL/h，能够提供与FNB等效的镇痛效果，同时对下肢肌力影响较小，相对安全有效；但医务人员仍需警惕患者跌倒可能性。在采用局部麻醉药物行ACB中联合应用辅助药物如右美托咪定、地塞米松等，可增强术后镇痛效果、延长镇痛时间；1 µg/kg右美托咪定神经周围给药可能同时兼顾安全性和镇痛疗效。. [Publisher, Chinese] ACB是膝关节置换术后一种安全有效的镇痛方法。由于收肌管内神经结构的高度变异性，收肌管解剖、ACB的最佳阻滞方法和阻滞位置存在较大争议，仍需进一步研究与探讨。. |
| المشرفين على المادة: | 67VB76HONO (Dexmedetomidine) 0 (Analgesics, Opioid) |
| تواريخ الأحداث: | Date Created: 20230128 Date Completed: 20230131 Latest Revision: 20230207 |
| رمز التحديث: | 20230207 |
| مُعرف محوري في PubMed: | PMC9883644 |
| DOI: | 10.7507/1002-1892.202210066 |
| PMID: | 36708123 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1002-1892 |
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| DOI: | 10.7507/1002-1892.202210066 |