Tác dụng ức chế cảm giác-vận động theo vùng thần kinh chi phối khi gây tê ống cơ khép giảm đau sau phẫu thuật nội soi khớp gối

Abstract

Objective: To evaluate the effect of sensory-motor blockade of saphenous nerve (SN), tibial nerve (TN) and common peroneal nerve (CPN) after adductor canal block (ACB) that was postoperative pain control following knee arthroscopy by bupivacain 0.25% dose 1mg/kg. Subject and method: 36 patients experience anterior cruciate ligament reconstruction (ACLR) under spinal anesthesia, ASA I - II, BMI < 30. When the efficacy of spinal anesthesia was finished, ACB by bupivacain 0.25%. To evaluate the sensory- motor blockade of SN, TN and CPN at 30 minutes, 60 minutes after ACB, the sensory blockade onset time of each nerves, VAS score at 30 minutes, 60 minutes, 3 hours, 6 hours and 12 hours. Result: 100% patients were sensory block of SN, 58.3% patients of TN and 52.7% patients of CPN, 2.8% patients were quadriceps muscle weakness, 0% patient were motor blockade for TN and CPN. The sensory blockade onset time of TN (n = 21) were 10.4 ± 10.2 munites and CPN were 12 ± 8.9 munites longer than time of SN (n = 36) (6.6 ± 2.7 munites), respectively, p<0.05. the VAS score both in dynamic state and at rest < 4 all times. Conclusion: ACB by 26.5ml LA volume buivacain 0.25% was postoperative pain control following knee arthroscopy, the sensory block was 100% for SN, 58.3% for TN and 52.7% for CPN, 2.8% quadriceps muscle weakness and without motor block for TN, CPN. The sensory blockade onset time of TN and CPN longer than SN, p<0.05, VAS points at the rest and the movement < 4 all times.