Use of a stimulating catheter for total knee replacement surgery: preliminary results.
Use of a stimulating catheter for total knee replacement surgery: preliminary results.
复制标题
使用刺激导管进行全膝关节置换手术：初步结果。
DOI：
10.1093/bja/aei161
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发表时间：
2005
影响因子：
9.8
通讯作者：
Vonhögen,LH
中科院分区：
文献类型：
--
作者：
Jack,NTM;Liem,EB;Vonhögen,LH
背景：关于使用电刺激辅助定位神经是否也有利于优化神经导管的放置并改善临床结果，如疼痛评分和阿片类药物消耗的减少，仍有持续的争论。方法：我们进行了回顾性研究，刺激和非刺激的非随机比较在2002年12月至2004年7月期间，对419例接受全膝关节置换术的患者进行了神经刺激导管的研究。手术前，患者接受坐骨神经和股神经阻滞与导管股神经。在159例患者中使用刺激导管系统（Stimucath; Arrow International，阅读，PA，USA），在260例患者中使用非刺激导管系统（Contiplex; B. Braun，Melsungen，德国）。手术后，疼痛评分和吗啡消耗量记录在4小时的时间间隔，直到术后第一天早上。在一个子集的85例患者，术后评估期延长至3 days.Results.Postoperative视觉模拟评分（VAS）的疼痛是相似的，在第一个24小时内，两组（P=0.305）。在随访3天的患者中，VAS评分在任何一天都没有差异（P=0.427）。总吗啡消耗量在术后第一天（平均值[95%CI]：刺激，12.4 [10.1-14.7] mg;非刺激10.4 [8.9-11.8] mg;P=0.140）或随后days.Conclusions.如先前研究者所报告的，刺激导管的实际优势在这种临床情况下并不明显。在疼痛评分和吗啡消耗量等结局指标方面，我们发现刺激性和非刺激性导管之间无显著差异。
Background.There is continuing debate as to whether the use of electrical stimulation that aids in localizing nerves is also beneficial for optimizing placement of nerve catheters and lead to improved clinical outcomes, such as reductions in pain scores and opioid consumption.Methods.We undertook a retrospective, non-randomized comparison of stimulating and non-stimulating nerve catheters in 419 patients undergoing total knee replacement between December 2002 and July 2004. Before surgery, patients received sciatic and femoral nerve blocks with a catheter for the femoral nerve. In 159 patients a stimulating catheter system (Stimucath; Arrow International, Reading, PA, USA) and in 260 patients a non-stimulating catheter system (Contiplex; B. Braun, Melsungen, Germany) was used. After surgery, pain scores and morphine consumption were recorded at 4-h intervals until the first postoperative morning. In a subset of 85 patients, the postoperative evaluation period was lengthened to 3 days.Results.Postoperative visual analogue scores (VAS) for pain were similar in the two groups during the first 24 h (P=0.305). In patients followed for 3 days, VAS scores did not differ on any of the days (P=0.427). Total morphine consumption did not differ on the first postoperative day (mean [95% CI]: stimulating, 12.4 [10.1–14.7] mg; non-stimulating 10.4 [8.9–11.8] mg;P=0.140) or on subsequent days.Conclusions.The practical advantages of the stimulating catheter, as reported by previous investigators, were not obvious in this clinical situation. In terms of outcome measures such as pain scores and morphine consumption, we found no significant differences between stimulating and non-stimulating catheters.