超声引导罗哌卡因复合地塞米松髂筋膜间隙阻滞应用于全膝关节置换术围术期的镇痛效果  

Analgesic effect of ultrasound-guided ropivacaine combined with dexamethasone fascia iliaca compartment block for perioperative period of total knee arthroplasty

作　　者：黄娟娟 胡焕盛 於国珍 安小凤[2] 王祥和[2] HUANG Juan-juan;HU Huan-sheng;YU Guo-zhen;AN Xiao-feng;WANG Xiang-he(Dept of Anesthesiology,the Third People′s Hospital of Huzhou City,Huzhou,Zhejiang 313000,China)

机构地区：[1]湖州市第三人民医院麻醉科,浙江湖州313000 [2]中国人民解放军陆军第72集团军医院麻醉科,浙江湖州313000

出　　处：《临床骨科杂志》2021年第1期71-74,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨超声引导罗哌卡因复合地塞米松髂筋膜间隙阻滞(FICB)在全膝关节置换术(TKA)围术期的镇痛效果。方法将行TKA治疗的48例患者根据随机数字表法分为观察组和对照组,每组24例。两组术前0.5 h均在超声引导下行FICB,观察组注入0.375%罗哌卡因30 ml+地塞米松10 mg,对照组注入0.375%罗哌卡因30 ml。观察两组围术期镇痛效果、术后48 h内阿片类药物用量、恶心呕吐发生率及FICB相关并发症。结果注药后12、24、36 h静息和运动疼痛VAS评分及术后镇痛泵按压次数观察组均低(少)于对照组,差异均有统计学意义(P<0.05);注药后3、6、8、48 h静息和运动VAS评分及恶心呕吐发生率两组比较差异均无统计学意义(P>0.05);两组均未发现FICB相关并发症。结论超声引导罗哌卡因复合地塞米松FICB较单独使用罗哌卡因能够延长术后镇痛时间,减少术后48 h内阿片类药物用量。Objective To investigate the analgesic effect of ultrasound-guided ropivacaine combined with dexamethasone fascia iliac compartment block(FICB)during perioperative period of total knee arthroplasty(TKA).Methods The 48 patients undergone TKA were randomly divided into observation group and control group according to the number table method,24 patients in each group.The two groups patients were performed with FICB under the ultrasound-guided at 0.5 h preoperation;30 ml of 0.375%ropivacacine with 10 mg of dexamethasone were used in the observation group,and 30 ml of 0.375%ropivacaine was used in the control group,respectively.Perioperative analgesic effect,opioid dosage within 48 h after operation,incidence rate of nausea and vomiting,and FICB related complications were observed in the two groups.Results VAS of the resting and exercise at 12,24,36 h after drug injection and the times of analgesia pump pressure in the observation group were both lower(less)than those of the control group(P<0.05);there was no differences of VAS of the resting and exercise at 3,6,8,48 h after drug injection,and incidence rate of nausea and vomiting between the two groups(P>0.05).No FICB related complications were found in either group.Conclusions Compared with ropivacaine alone,ultrasound-guided ropivacaine combined with dexamethasone FICB can prolong postoperative analgesia time and reduce opioid dose at 48 h postoperation.

关 键 词：超声引导 髂筋膜间隙阻滞 全膝置换术 罗哌卡因 地塞米松 

分 类 号：R687.4[医药卫生—骨科学] R614.4[医药卫生—外科学]