右美托咪定复合罗哌卡因用于连续股神经阻滞在全膝关节置换术后镇痛效果的观察  

Observation on the Analgesic Effect of Dexmedetomidine Combined with Ropivacaine for Continuous Femoral Nerve Block after Total Knee Arthro⁃plasty

作　　者：朱怀礼 余艾华 汪亚 ZHU Huaili;YU Aihua;WANG Ya(Department of Anesthesiology,Danyang People's Hospital,Danyang,Jiangsu Province,212300 China)

机构地区：[1]丹阳市人民医院麻醉科,江苏丹阳212300

出　　处：《系统医学》2023年第24期82-85,共4页Systems Medicine

摘　　要：目的探讨在全膝关节置换术后镇痛中采用右美托咪定复合罗哌卡因用于连续股神经阻滞的效果。方法选择2021年1月—2022年12月于丹阳市人民医院行全膝关节置换术治疗的90例患者为研究对象,按随机数表法分组,对照组予罗哌卡因、观察组再加右美托咪定,每组45例。比较两组术后各时间静息与被动活动疼痛程度、术后恢复情况、麻醉不良反应。结果观察组术后4、8、12、24 h时静息疼痛评分各为(1.25±0.25)、(1.47±0.23)、(2.25±0.36)、(3.03±0.44)分,低于对照组,差异有统计学意义(t=10.561、13.775、9.004、11.029,P均<0.05);而术后36、48 h时静息疼痛评分与对照组比,差异无统计意义(P均>0.05)。观察组患者在术后4、8、12、24、36、48 h被动活动疼痛评分均低于对照组,差异有统计学意义(P均<0.05)。观察组术后自控泵有效按压次数少于对照组,术后下床活动时间、主动直腿抬高时间以及屈膝90°时间短于对照组,差异有统计学意义(P均<0.05)。观察组麻醉不良反应率低于对照组,差异有统计学意义(P<0.05)。结论在全膝关节置换术后镇痛连续股神经阻滞中联合运用右美托咪定、罗哌卡因的效果显著,能明显控制患者术后静息与活动疼痛,并有助于患者术后肢体功能的恢复,且麻醉不良反应较少。Objective To investigate the effect of dexmedetomidine combined with ropivacaine for continuous femoral nerve block in postoperative analgesia after total knee arthroplasty.Methods 90 patients who underwent total knee ar⁃throplasty treatment in Danyang People's Hospital from January 2021 to December 2022 were selected as the study objects and grouped according to the randomized number table method.The control group was given ropivacaine,the observation group then added dexmedetomidine,n=45.The two groups were compared with each postoperative time of resting and passive activity pain level,postoperative recovery,and anesthesia adverse reaction.Results The resting pain scores of the observation group were(1.25±0.25),(1.47±0.23),(2.25±0.36),and(3.03±0.44)points at 4,8,12,and 24 h postoperatively,which were lower than those of the control group,the differences were statistically significant(t=10.561,13.775,9.004,11.029,all P<0.05),respectively.And there were no statistical significances in the resting pain score at 36 and 48 h postoperatively compared with the control group(both P>0.05).The passive activity pain scores of the observation group were lower than those of the control group at 4,8,12,24,36 and 48 h after operation,the differences were statistically significant(all P<0.05).In the observation group,the number of effective postopera⁃tive presses of the self-control pump was less than that of the control group,and the postoperative time of getting out of bed,the time of active straight-leg raising,and the time of bending the knee at 90°were shorter than those of the control group,the differences were statistically significant(all P<0.05).The rate of adverse reactions to anesthesia in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The combined use of dexmedetomidine and ropivacaine in continuous femoral nerve block for postopera⁃tive analgesia after total knee arthroplasty is effective in controlling the patients'postope

关 键 词：右美托咪定 罗哌卡因 连续股神经阻滞 全膝关节置换术 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]