不同浓度罗哌卡因在老年髋关节全麻手术中的应用  

Application of Different Concentrations of Ropivacaine in General Anesthesia of the Hip in the Elderly

作　　者：郭玮 杨晓斌 华东 陈美银[2] Guo Wei;Yang Xiaobin;Hua Dong(Department of Anesthesiology,Ma’anshan General Hospital of Ranger-Duree Healthcare,Ma’anshan,Anhui,241000,China)

机构地区：[1]德驭医疗马鞍山总医院麻醉科,安徽马鞍山243000 [2]马鞍山市人民医院麻醉科,安徽马鞍山243000

出　　处：《黑龙江医学》2023年第23期2851-2854,共4页Heilongjiang Medical Journal

摘　　要：目的:比较不同浓度的罗哌卡因在老年髋关节全麻手术中的效果,以期对临床应用提供参考。方法:选取2019年1—12月德驭医疗马鞍山总医院行髋关节手术的120例患者作为研究对象,随机分为A、B、C3组(n=40),分别使用0.250%、0.375%、0.500%的罗哌卡因行髂筋膜间隙阻滞(FICB)联合全麻。对比3组阿片类药物的用量,术后6 h、12 h、24 h镇痛效果及运动功能,术后恶心呕吐反应及康复依从性。结果:B组和C组术后6 h、12 h、24 h的运动疼痛评分均低于A组,且C组术后24 h运动痛低于B组,差异有统计学意义(F=2.330、1.769、2.232;9.481、8.222、3.953;F=3.953、4.783、4.866;5.214、4.731、3.827,P<0.05);A组术后24 h内恶心呕吐程度高于B、C两组,康复依从性和舒适度低于B、C两组,差异有统计学意义(F=11.905、6.395、12.405,P<0.05)。结论:0.375%罗哌卡因行FICB用于老年髋关节全麻手术镇痛效果好,恶心呕吐程度轻且术后运动功能更佳。Objective:To compare the advantages and disadvantages of three concentrations of ropivacaine for iliofascial gap block in general anesthesia for hip surgery in the elderly,in order to provide a reference for clinical application.Methods:120 patients who underwent hip surgery in the hospital from January to December 2019 were selected and randomly divided into A,B,C,groups,with 40 cases in each group.0.250%,0.375%and 0.500%ropivacaine was used in groups A(0.25%),B(0.375%),and C(0.5%)for iliac fascia gap block(FICB)combined with general anesthesia,respectively.The opioid dosage,analgesic effect and motor function at 6 h,12 h and 24 h postoperatively,postoperative nausea and vomiting response and rehabilitation compliance of the three groups were compared.Results:The motor pain scores at 6 h,12 h,and 24 h postoperatively were lower in groups B and C than in group A,and the motor pain at 24 h postoperatively was lower in group C than in group B,and the differences were statistically significant(F=2.330,1.769,2.232;9.481,8.222,3.953;3.953,4.783,4.866;5.214,4.731,3.827,P<0.05).The degree of nausea and vomiting within 24 h after surgery was higher in group A than in groups B and C.The compliance and comfort of rehabilitation were lower than in groups B and C,and the differences were statistically significant(F=11.905,6.395,12.405,P<0.05).Conclusion:FICB with 0.375%ropivacaine for general anesthesia of the hip in the elderly is effective in analgesia,with less nausea and vomiting and better postoperative motor function.

关 键 词：罗哌卡因 老年髋关节手术 镇痛 不良反应 

分 类 号：R614[医药卫生—麻醉学]