不同浓度罗哌卡因切口持续浸润用于膝关节置换患者术后镇痛效果比较  

Comparison of postoperative analgesic effect of different concentration ropivacaine infiltration at knee replacement

作　　者：叶绍兵[1] 余洋 魏勤 YE Shaobing;YU Yang;WEI Qin(Department of Anesthesiology,Institute of Field Surgery,Daping Hospital,Third Military Medical University,Chongqing 400042,China)

机构地区：[1]第三军医大学附属大坪医院野战外科研究所麻醉科,重庆400042

出　　处：《现代仪器与医疗》2018年第1期128-130,共3页Modern Instruments & Medical Treatment

摘　　要：目的:探讨不同浓度罗哌卡因切口持续浸润用于膝关节置换患者术后镇痛的临床效果。方法:择期行单侧膝关节置换手术患者120例,随机分为A、B、C组,每组各40例,分别采用0.1%(A组)、0.3%(B组)、0.5%(C组)罗哌卡因切口持续浸润。评估3组患者术后不同时间点的VAS疼痛评分、术后康复训练依从性、膝关节主动活动度(ROM)、膝关节功能(HSS)及术后并发症的发生情况。结果:B、C组术后72h安静及活动时VAS评分明显高于A组(P<0.05),B、C2组VAS评分差异无统计学意义。3组患者术后72h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),B、C2组术后康复训练依从性、膝关节主动活动度(ROM)、膝关节功能(HSS)评分均优于A组(P<0.05),A、B2组术后肢体麻木的发生率显著低于C组,差异有统计学意义,3组其余并发症的发生情况差异无统计学意义(P>0.05)。结论:全膝关节置换术患者采用0.3%罗哌卡因切口持续浸润不仅可以取得良好的术后镇痛而且有助于术后膝关节功能的恢复。Objective:The objective of this study was to compare the postoperative analgesic effect of different concentration ropivacaine infiltration at knee replacement.Methods:A total of 120 patients,undergoing unilateral knee replacement were randomly divided into Group A,B and C,with 40 in each group.These groups were respectively given 0.1%,0.3%and 0.5%ropivacaine infiltration.The Visual Analogue Scale(VAS),postoperative rehabilitation training compliance and active range of motion(AROM),hospital for special surgery(HSS)and complications of three groups at different time points were compared.Results:The VAS score both in resting and ambulatory state of Group B and C at the time point of 72 h after operation were significantly higher than those of Group A(P<0.05),the differences of Group B and C were not statistically significant.The differences of the VAS score of these three groups both in resting and ambulatory state at the time point of 72 h after operation and one week were not statistically significant(P>0.05).The compliance,ROM,HSS of Group B and C better than that of Group A(P<0.05),and the incidence of numbness of the limbs of Group A and B was lower than that of Group C,the differences were statistically significant.The incidence of complications in these three groups had no statistical difference(P>0.05).Conclusion:0.3%ropivacaine infiltration at total knee replacement patients has a better analgesic effect and improves their knee function recovery.

关 键 词：罗哌卡因 切口持续浸润 全膝关节置换术 

分 类 号：R614[医药卫生—麻醉学]