右美托咪定复合罗哌卡因收肌管阻滞对膝关节置换术后早期恢复质量的影响  

Effect of adductor canal block with dexmedetomidine and ropivacaine on the postoperative early quality of recovery after total knee arthroplasty

作　　者：林莹[1] 廖燕凌[1] 姚玉笙[1] 郑晓春[1] Lin Ying;Liao Yanling;Yao Yusheng;Zheng Xiaochun(Department of Anesthesiology,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院麻醉科福建医科大学省立临床学院麻醉教研室,福州350001

出　　处：《国际医药卫生导报》2018年第23期3635-3638,共4页International Medicine and Health Guidance News

摘　　要：目的 评估右美托咪定复合罗哌卡因收肌管阻滞对膝关节置换术后早期恢复质量的影响。方法 纳入2017年10—12月单侧全膝关节置换术患者50例,均分为2组行患侧收肌管阻滞,每组25例。S组注射0.5%罗哌卡因20 ml;D组注射0.5%罗哌卡因+右美托咪定(DEX)1μg/kg共20 ml。术后给予静脉自控镇痛。计算患者术前1 d和术后24 h的QoR-40量表分值。记录术后24 h内恶心呕吐、心动过缓等不良反应发生率、PCA按压次数。结果 与S组比较,D组术后24 h QoR-40总分及各项评分均升高:QoR-40总分(173分比152分),情绪状态(39分比34分),身体舒适度(50分比45分),心理支持(33分比31分),疼痛(32分比28分),自理能力(19分比14分);PCA按压次数明显减少(1次比6次),差异均有统计学意义(均P<0.05)。两组患者在恶心呕吐、心动过缓等不良反应发生率上均无明显差异。结论 右美托咪定复合罗哌卡因超声引导下收肌管阻滞能够提高膝关节置换术后早期的恢复质量,促进术后快速康复。Objective To evaluate the effect of adductor canal block(ACB)with dexmedetomidine and ropivacaine on the postoperative early quality of recovery after total knee arthroplasty.Methods Fifty patients undergoing unilateral total knee arthroplasty were enrolled from October 2017 to December 2017 were randomly divided into two groups,25 cases in each group.Group S received ACB with 20 ml of 0.5%ropivacaine,and group D received ACB with 20 ml of 0.5%ropivacaine and dexmedetomidine 1μg/kg.PCIA was performed after surgery.The score of QoR-40 was calculated at 1 day before and 24 hours after surgery.The incidence of adverse reactions such as nausea and vomiting,bradycardia,and the number of PCA compressions were recorded within 24 hours after surgery.Results Compared with group S,the total score and each item score of QoR-40 increased at 24 hours after surgery in group D:the total score(173 vs.152),emotional state(39 vs.34),physical comfort(50 vs.45),psychological support(33 vs.31),pain(32 vs.28),physical independence(19 vs.14);the number of PCA compressions significantly reduced(1 vs.6)(P<0.05).There was no statistically significant difference in the incidence of adverse reactions such as nausea and vomiting,bradycardia between the two groups.Conclusion Ultrasound-guided adductor canal block with dexmedetomidine and ropivacaine can improve the postoperative early quality of recovery after total knee arthroplasty,and enhance the recovery after surgery.

关 键 词：右美托咪定 收肌管阻滞 膝关节置换术 早期恢复质量 

分 类 号：R614[医药卫生—麻醉学]