罗哌卡因注射液局部注射对全膝关节置换术后镇痛及功能恢复的影响  

Effect of local injection of ropivacaine on the analgesia and function recovery after total knee arthroplasty

作　　者：吕欧[1] 李军[1] 吴伟[1] 韩雪敏[2] 汤海珍[2] 

机构地区：[1]安徽省淮北市人民医院骨科,235000 [2]安徽省淮北市人民医院麻醉科,235000

出　　处：《蚌埠医学院学报》2015年第8期1066-1069,共4页Journal of Bengbu Medical College

摘　　要：目的：观察全膝关节置换术（TKA）后在静脉自控镇痛治疗的基础上使用罗哌卡因局部注射的镇痛效果及其对早期功能锻练的影响。方法：90例初次单侧TKA的患者随机分为2组,每组45例。对照组采取静脉自控镇痛治疗,观察组采取罗哌卡因复合液术中关节周围注射配合术后静脉自控镇痛治疗,采用视觉模拟评分法（VAS）评估并比较2组患者术后6、12、24、48、72 h及术后1周患膝静止及运动状态下的疼痛情况。测量术后24、48、72 h及术后1周的膝关节活动度,观察患者术后有无头晕、恶心、呕吐、肢体麻木等并发症。结果：观察组术后6、12、24、48 h静息状态及活动状态下VAS评分均低于对照组（P〈0.05-P〈0.01）,2组术后72 h及术后1周静息状态及活动状态下VAS评分差异均无统计学意义（P〉0.05）,术后早期（72 h内）观察组活动范围明显好于对照组（P〈0.01）。结论：TKA术中罗哌卡因复合液关节周围注射进行镇痛治疗是一种简单、有效、价廉的治疗方法,操作简便,术后镇痛效果明显,有助于膝关节功能的恢复。Objective： To observe the effects of local injection of ropivacaine combined with patient-controlled intravenous analgesia on the analgesia and early functional exercise after total knee arthroplasty（ TKA）. Methods： Ninety patients with primary unilateral TKA were randomly divided into the control group and observation group（ 45 cases each group）. The control group and observation group were treated with patient-controlled intravenous analgesia and periarticular local injection of ropivacaine combined with patientcontrolled intravenous analgesia,respectively. The knee pain at stationary and moving state between two groups after 6,12,24,48,72 h and 1 week of operation were evaluated and compared using the visual analogue scale（ VAS）. The range of motion of knee joint in two groups after 24,48,72 h and 1 week of operation were measured. The postoperative dizziness,nausea,vomiting and numbness of the limbs in two groups were observed. Results： The VAS scores in observation group at stationary and moving state after 6,12,24 and 48 h of operation were less than that in control group（ P〈0.05 to P〈0.01）. The differences of the VAS scores at stationary and moving state between two groups after 72 h and 1 week of operation were not statistically significant（ P〉0.05）. The early range of motion in observation group was significantly better than that in control group（ P〈0.01）. Conclusions： The periarticular local injection of ropivacaine in the treatment of pain during TKA is a simple,effective and low cost,and which has obviously postoperative analgesic effect,and can contribute to the recovery of knee joint function.

关 键 词：罗哌卡因 膝关节置换 镇痛 

分 类 号：R453.9[医药卫生—治疗学]