连续股神经阻滞复合芬太尼用于膝关节手术镇痛的观察  

Application of Continuous Femoral Nerve Block Compound Fentanyl in Knee Joint Operation Analgesia

作　　者：余根远[1] 

机构地区：[1]福建省南平市第一医院麻醉科,福建南平353000

出　　处：《中国卫生标准管理》2017年第28期153-156,共4页China Health Standard Management

摘　　要：目的比较连续股神经阻滞复合芬太尼与全凭静脉镇痛在膝关节镜手术中的镇痛效果。方法从2015年1月—2017年6月期间,选择40例随机分为2组,每组20例。两组均采用全身麻醉完成手术。连续股神经阻滞组配方为0.2%罗哌卡因+芬太尼1μg/ml共100 ml,负荷量10 ml,持续输注量5 ml/h,PCA 3 ml,锁定时间15 min。静脉镇痛泵组配方为舒芬太尼1.5μg/ml+氟吡洛酚脂1 mg/ml共100ml,持续输注量2 ml/h,PCA 0.5 ml,锁定时间10 min。观察手术后6 h,12 h,24 h两组自主运动和静息时镇痛效果以及两组副作用恶心呕吐,头晕,皮肤瘙痒,尿潴留程度。结果连续股神经阻滞镇痛组的视觉模拟评分(VAS)无论在自主运动和静息时都低于静脉镇痛泵组(P<0.05)。呕吐,头晕,皮肤瘙痒,尿潴留等副作用连续股神经阻滞镇痛组也低于静脉镇痛泵组(P<0.05)。结论连续股神经阻滞复合芬太尼用于膝关节手术镇痛,效果好,并发症少,促进患者术后功能锻炼康复,是多模式镇痛中的一个可选择的方法。Objective The analgesic effect of continuous femoral nerve block compound fentanyl was compared with the analgesic analgesia in the knee arthroscopic surgery. Methods From January 2015 to June 2017, 40 cases were randomly divided into two groups, each group with 20 cases. Both groups underwent general anesthesia to complete the operation. The formula of the continuous femoral nerve block group was 0.2% ropivacaine ＋ fentanyl 1μg /ml, 100 ml, 10 ml of load, 5 ml/h of continuous infusion, 3 ml PCA, and 15 minutes of locking time. The formula of the intravenous analgesic pump group was sufentanil 1.5 μg / ml ＋ fuoropyropolol 1 mg / ml, total 100 ml, 2ml/h of continuous infusion, PCA 0.5 ml, for 10 minutes. After the operation, 6 h, 12 h, 24 h autonomic movement and the analgesic effect of the two groups were observed, both nausea and vomiting, dizziness, skin itching, and urinary retention of two groups were compared. Results The visual analogue score （VAS） of the continuous femoral nerve block analgesic group was lower than the analgesic pump group （P 〈 0.05）, in both autonomous and static analgesia, vomiting, dizziness, skin itching, urinary retention and other side effects of continuous femoral nerve block analgesia group were also lower than those of venous analgesic pump （P 〈 0.05）. Conclusion Continuous femoral nerve block compound fentanyl analgesia for knee surgery, good effect in patients with fewer complications promote postoperative functional exercise rehabilitation, is a choice of multimodal analgesia method.

关 键 词：股神经 芬太尼 罗哌卡因 术后镇痛 膝关节 

分 类 号：R722[医药卫生—儿科]