罗哌卡因连续股神经阻滞联合鸡尾酒疗法在全膝关节置换术后镇痛中的应用效果  

Efficacy of continuous femoral nerve block using ropivacaine combined with cocktail therapy applied to analgesia after total knee arthroplasty

作　　者：黎裕星 邓双钊 黎诠初 陆立仁[1] 莫平[1] LI Yu-xing;DENG Shuang-zhao;LI Quan-chu;LU Li-ren;MO Ping(Department of Anesthesiology,Nanhai District People＇s Hospital of Foshan City,Foshan 528200,China)

机构地区：[1]广东省佛山市南海区人民医院麻醉科,佛山市528200

出　　处：《广西医学》2018年第17期1962-1964,共3页Guangxi Medical Journal

摘　　要：目的探讨罗哌卡因连续股神经阻滞联合鸡尾酒疗法在全膝关节置换术后镇痛中的应用效果。方法将80例择期行单侧全膝关节置换术患者,按随机数字表法分为观察组与对照组,每组40例。对照组患者给予术中膝关节注射鸡尾酒注射液进行镇痛,观察组患者在对照组基础上术后行罗哌卡因股神经连续阻滞镇痛。观察两组术后2 h、6 h、12 h、24 h、48 h静息及运动疼痛视觉模拟量表(VAS)评分,比较两组患者改良Bromage评分及满意度。结果两组的静息VAS评分及运动VAS评分差异均有统计学意义,均有随时间变化的趋势,分组与时间均有交互效应,其中观察组术后24 h、48 h的静息VAS评分及术后6 h、12 h、24 h、48 h的运动VAS评分均低于对照组(均P<0.05)。两组患者术后改良Bromage评分均为0分;观察组对镇痛的满意度高于对照组(P<0.05)。结论罗哌卡因连续股神经阻滞镇痛联合鸡尾酒疗法用于全膝关节置换术后镇痛,可减轻患者术后疼痛,且不影响患者术后早期的运动康复。Objective To investigate the efficacy of continuous femoral nerve block using ropivacaine combined with cocktail therapy applied to analgesia after total knee arthroplasty. Methods Eighty patients undergoing elective unilateral total knee arthroplasty were divided into observation group and control group according to the random number table method, with 40 cases in each group. The control group was given intraoperative cocktail injection for knee analgesia,while the observation group was given postoperative continuous femoral nerve block analgesia using ropivacaine on the basis of the procedures in the control group. The resting and motor Visual Analogue Scale （ VAS ） scores were observed in both groups at 2 h,6 h, 12 h,24 h and 48 h after operation. The modified Bromage score and satisfaction were compared between the two groups. Results There were significant differences in the resting and motor VAS scores between the two groups, presenting a tendency to change with time in both groups, there was an interaction between grouping effect and time effect, and the resting VAS scores at 24 h and 48 h after operation,as well as the motor VAS scores at 6 h, 12 h,24 h and 48 h after operation,in the observation group were all lower than those in the control group（ all P 〈 0.05 ）. The postoperative modified Bromage scores were 0 point in both groups,and the satisfaction to analgesia in the observation group was higher than that in the control group （P 〈 0. 05 ）. Conclusion Continuous femoral nerve block analgesia using ropivacaine combined with cocktail therapy applied to analgesia after total knee arthroplasty can alleviate postoperative pains and does not affect the patients＇ exercise rehabilitation in the early stage of postoperation.

关 键 词：全膝关节置换术 罗哌卡因 连续股神经阻滞 鸡尾酒疗法 术后 镇痛 

分 类 号：R687.4[医药卫生—骨科学]