术中多模式药物注射对腕部术后疼痛控制的影响  

The efficacy of intraoperative multimodal analgesic injection for postoperative pain control following wrist surgery

作　　者：王思群[1] 王世龙[1] 汤超亮[1] 陈文钧[1] 

机构地区：[1]复旦大学附属华山医院骨科,上海200040

出　　处：《中华手外科杂志》2009年第4期242-244,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨术中多模式药物注射对腕部术后疼痛控制的影响。方法2006年9月-2008年10月，对62例桡骨远端骨折需手术的患者，采用掌侧Henry入路和AO掌侧钢板固定。术中将患者随机分成两组：多模式药物注射组（MI组）和非多模式药物周围注射组（NMI组）。多模式药物注射混合液由罗哌卡因、吗啡、复方倍他米松和肾上腺素配方组成。观察患者术后疼痛情况（VAS）包括静息痛、运动疼痛，并监测术后阿片类药物使用量和并发症。结果 MI组术后静息疼痛和运动疼痛评分均比NMI组低，术后阿片类镇痛药物使用量比NMI组少，两组间差异有统计学意义。术后两组均无并发症发生。结论术中多模式药物注射能有效地控制腕部手术术后的疼痛且并发症少，有利于腕关节功能的恢复。Objective To investigate the clinical efficacy of intraoperative multimodal analgesic injection for postoperative pain control following wrist surgery. Methods From September 2006 to October 2008, 62 patients with distal radius fractures were surgically treated. All fractures were stabilized with AO volar plates via Henry approach. Intraoperatively the patients were randomized to either receive an intraoperative multimodal analgesic injection containing ropivacaine, epimorphine, betamethasone and epinephrine （Group MI） or to receive no injection （Group NMI）. Visual analog scores for postoperative pain during rest and activity were recorded. Narceties consumption and the side effects were monitored. Results Visual analog scores for pain during rest and postoperative activity in Group MI were lower than those in Group NMI with statistically significant differences, Them was less postoperative narcotics consumption in Group MI than in Group NMI. No complications were found in both groups. Conclusion Intraoperative multimedal analgesic injection is an effective approach to control postoperative pain following wrist surgery. It can lead to a quick functional recovery in patients with less complications.

关 键 词：腕 外科手术 注射 多模式镇痛 

分 类 号：R686[医药卫生—骨科学]