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目的:分析超声引导下髂筋膜间隙阻滞(FICB)、收肌管阻滞(CACB)在膝关节置换术后镇痛中的应用效果。方法:选取2016年5月至2018年4月四川省骨科医院麻醉科拟择期行全膝关节置换术(TKA)患者84例为研究对象，按随机数字表法分为观察组、对照组各42例，观察组于超声引导下行FICB阻滞，对照组于超声引导下接受CACB阻滞，比较两组术后镇痛效果[静息与运动状态下疼痛视觉模拟评分(VAS)]、主要神经感觉阻滞率、应激反应[皮质醇(Cor)、血糖(Glu)]、股四头肌肌力及并发症。结果:两组术后各时点静息状态下VAS评分比较差异无统计学意义(n P>0.05)，而观察组术后12、24、48 h运动状态下VAS评分低于对照组(n P0.05). The VAS scores at exercise state of the observation group were lower than those of the control group at 12 h, 24 h and 48 h after operation (n P<0.01). The block rate of lateral femoral cutaneous nerve in the observation group was higher than that in the control group at 5 min, 10 min, and 30 min after block (n P0.05). The levels of blood cortisol and blood glucose in the observation group were significantly lower than those in the control group at 24 h and 48 h after operation (n P<0.05). The muscle strength of quadriceps femoris in the observation group was lower than that in the control group at 24 h and 48 h after operation (n P0.05).n Conclusions:Both FICB and CACB can significantly improve resting pain and femoral nerves in patients after total knee arthroplasty. FICB has advantages in blocking lateral femoral cutaneous nerve, controlling postoperative exercise pain and reducing stress response, while CACB has better effects on improving muscle strength of quadriceps femoris. The safety of the two groups is comparable. And each has its own advantages and disadvantages.