关键词: 膝关节镜下前交叉韧带重建术, 收肌管阻滞, 闭孔神经阻滞, 镇痛, 膝关节功能

Abstract: Objective To study the effect of adductor canal combined with obturator nerve block on analgesia and functional rehabilitation of patients undergoing arthroscopic anterior cruciate ligament(ACL) reconstruction.
Methods 60 patients undergoing arthroscopic ACL reconstruction who received therapy from November 2019 to March 2020 in our hospital were selected,they were divided into the observation group and the control group by the the random number table,each group had 30 cases,the observation group was treated with adductor canal combined with obturator nerve block intraoperative,while the the control group was treated with only obturator nerve block intraoperative,The postoperative visual analogue scale(VAS),analgesia,joint function recovery and safetys were compared between the two groups.
Results At postoperative 4h,8h,12h,24h,48h,the rest and activity VAS scores in the observation group were significantly lower than those in the control group(P<0.05);within postoperative 48 hours,the tramadol dosage and number of receiving lornoxicampatients in the observation group were significantly less than those in the control group(P<0.05);at postoperative 72h,the knee joint in American Special Surgery Hospital(HSS) scores in the observation group was significantly higher than those in the control group,and the active straight leg raising time,passive knee flexion 90° time and hospitalization were significantly shorter than those in the control group(P<0.05);there were no complications such as hematoma and hemorrhage at puncture site,local anesthetic poisoning and deep vein thrombosis of lower extremity in the two groups,and there was no significant difference in the incidence of decrease of quadriceps femoris muscle strength,nausea,vomiting and skin pruritus between the two groups(P＞0.05).
Conclusion Compared with single adductor canal block,adductor canal block combined with obturator block has more satisfactory analgesic effect on patients undergoing arthroscopic ACL reconstruction,which can promote the rehabilitation of joint function after operation,and has good safety,it's worthy of application and promotion.

Key words: arthroscopic anterior cruciate ligament reconstruction, adductor canal block, obturator block, analgesia, knee joint function