右美托咪定复合罗哌卡因对膝关节置换术后病人睡眠以及肌力影响  

EFFECT OF DEXMEDETOMIDINE COMBINED WITH ROPIVACAINE ON SLEEP AND MUSCLE STRENGTH OF PATIENTS AFTER KNEE ARTHROPLASTY

作　　者：代淑贞 刘英志[1] 马晓军[1] 黄辉[1] 刘少艳[1] 刘勇[1] DAI Shuzhen;LIU Yingzhi;MA Xiaojun;HUANG Hui;LIU Shaoyan;LIU Yong(Anesthesiology Department,The Affiliated Hospital with Qingdao University,Qingdao 266100,China)

机构地区：[1]青岛大学附属医院麻醉科,山东青岛266100

出　　处：《青岛大学学报（医学版）》2018年第4期400-403,共4页Journal of Qingdao University(Medical Sciences)

摘　　要：目的探讨不同剂量右美托咪定复合4g/L罗哌卡因股神经阻滞对膝关节置换术后病人的睡眠以及肌力影响。方法选取90例择期行膝关节置换术的病人,随机分成G1、G2、G3组,每组30例。G1组给予4g/L的罗哌卡因25 mL;G2组给予右美托咪定0.5μg/kg+4g/L罗哌卡因25 mL;G3组给予右美托咪定1.0μg/kg+4g/L罗哌卡因25mL。观察并比较3组病人术前以及术后1、2d的阿森斯失眠量表(AIS)失眠评分,术后12、24、48h的疼痛视觉模拟评分(VAS评分)、Ramsay镇静评分、恶心呕吐(PONV)评分以及肌力恢复情况。结果与G1组和G2组比较,G3组术后第1天的AIS失眠评分和术后12h肌力显著改善(F=3.871,H=7.660,P<0.05);与G1组相比,G2组和G3组术后12、24、48h的VAS评分显著降低(F=4.575~5.567,P<0.05)。G1、G2、G3组各时间点的Ramsay镇静评分、PONV评分比较差异无显著性(P>0.05)。结论右美托咪定1.0μg/kg+4g/L的罗哌卡因用于膝关节置换术能减轻病人术后疼痛,改善病人术后睡眠,缩短术后制动时间。Objective To investigate the effect of different doses of dexmedetomidine combined with 4 g/L ropivacaine for femoral nerve block on the sleep and muscle strength of patients after knee arthroplasty. Methods A total of 90 patients who underwent selective knee arthroplasty were enrolled and randomly divided into G1,G2,and G3 groups,with 30 patients in each group.The patients in the G1 group were given 4 g/L ropivacaine 25 mL,those in the G2 group were given 25 mL dexmedetomidine 0.5μg/kg＋ropivacaine 4 g/L,and those in the G3 group were given 25 mL dexmedetomidine 1.0μg/kg＋ropivacaine 4 g/L.The three groups were compared in terms of Athens Insomnia Scale（AIS）score before surgery and on days 1 and 2 after surgery,and Visual Analogue Scale（VAS）score,Ramsay sedation score,and postoperative nausea and vomiting（PONV）score at 12,24 and 48 hafter surgery,as well as muscle strength recovery. Results Compared with the G1 group and the G2 group,the G3 group had significant improvements in the AIS score on day 1 after surgery and muscle strength at 12 hafter surgery（F=3.871,H =7.660,P〈0.05）.Compared with the G1 group,the G2 and G3 groups had a significant reduction in the VAS score at 12,24,and 48 hafter surgery（F=4.575-5.567,P〈0.05）.There were no significant differences in Ramsay sedation score and PONV score between the G1,G2,and G3 groups at each time point（P〉0.05）. Conclusion Dexmedetomidine 1.0μg/kg combined with ropivacaine 4 g/L used for patients undergoing knee arthroplasty can reduce their postoperative pain,improve their postoperative sleep,and shorten the immobilization time after surgery.

关 键 词：右美托咪定 罗哌卡因 关节成形术 置换 膝 睡眠 肌力 

分 类 号：R611.1[医药卫生—外科学]