| ObjectiveTo compare the effect of pulse femoral nerve block guided by nerve stimulator with ultrasound and constant-speed femoral nerve block on patella fracture postoperative analgesia.MethodsThe patients who were conducted with open reduction internal fixation for patella fracture in Wuzhong People’s Hospital of Suzhou City from Oct.2016 to Aug.2018 were selected to be performed with continuous femoral nerve block anesthesia under the guidance of nerve stimulator with ultrasound.The patients were divided into observation group and control group in the random fashion.The mode of continuous constant-speed femoral nerve block administration analgesia was applied to the control group,while the mode of pulse femoral nerve block administration analgesia was applied to the observation group.The degree of pain for the patients in the state of still and motion after being conducted with femoral nerve block was evaluated by means of numerical rating scale(NRS),and the NRS of the two groups at 6h,12h,24h,36h and 48h were compared respectively,in the meantime,the usage rate of postoperative analgesia drugs and the patients’ satisfaction with postoperative analgesia for the two groups were compared.The measure materials were expressed with mean±standard deviation(x±s),and comparison among the groups was tested with Student’s test(t test);count materials was verified with Fisher’s exact test;the parameters of NRS was expressed with median,rank sum test was used for comparison among the groups.If P<0.05,the difference has statistical significance.ResultsThe NRS for the observation group in the state of still 6h,36h and 48h after being conducted with femoral nerve block was 1(0-2),2(1-3)and 2(1-2)respectively,and the NRS for the control group was 1(0-2),2(2-3)and 2(1-3).The comparison between the NRS for the two groups had no statistical significance.The NRS for the observation group in the state of still 12h,and 24h after being conducted with femoral nerve block was 2(1-3)and 2(1-3)respectively,which is less than the NRS of 3(2-5)and 3(2-4)for the control group.The comparison of the corresponding time points was P<0.05 which indicated that the difference had statistical significance.The NRS for the observation group in the state of motion at 6h,36h and 48h was 1(0-2),2(2-4)and 3(2-4)respectively,and the NRS for the control group was 1(0-2),3(2-5)and 2(2-4).The comparison between the NRS for the two groups had no statistical significance.The NRS for the observation group in the state of motion 12h,and 24h after being conducted with femoral nerve block was 3(2-5)and 3(2-4)respectively,which is less than the NRS of 4(3-6)and 4(2-5)for the control group.The comparison of the corresponding time points was P<0.05 which indicated that the difference had statistical significance.The postoperative usage rate of Tramadol for the observation group was 10%,which,compared to 40%for the control group,reduced apparently.The difference had statistical significance.The postoperative occurrence rate of nausea and emesis for the patients in the observation group was 5%,which,compared to 30%for the patients in the control group,reduced apparently,P<0.05.The difference had statistical significance.While the adverse reaction of skin itch for the two groups did not occur,and the difference had no statistical significance.The score of postoperative analgesia satisfaction for the patients in the observation control at 48h was(8.3±0.73),while the score was(7.5±0.76)for the control group.The difference was of no statistical significance.ConclusionsThe modes of femoral never pulse and constant-speed administration can provide effective analgesia for postoperative pain for patella fracture.However,pulse administration can produce better analgesia effect within 24 hours after operation compared to constant-speed administration mode.Whether in a resting state or in a moving state,the analgesia drugs supplemented after operation obviously reduced,and the occurrence rate of such adverse reactions as nausea,emesis,etc.decreased apparently. |
PDF Full Text Request