超声引导下罗哌卡因复合布托啡诺腰丛-骶丛神经阻滞对人工股骨头置换术患者术后疼痛的影响  

Effects of ultrasound-guided ropivacaine combined with butorphanol for lumbo-sacral plexus block on pain in patients after artificial femoral head replacement

作　　者：邓等良 方小林 王涛 吕志军 邱敏 DENG Dengliang;FANG Xiaolin;WANG Tao;LYU Zhijun;QIU Min(Department of Anesthesiology,Guixi Hospital of Traditional Chinese Medicine,Yingtan,Jiangxi,335400,China)

机构地区：[1]贵溪市中医院麻醉科,江西鹰潭335400

出　　处：《当代医学》2024年第16期45-49,共5页Contemporary Medicine

摘　　要：目的探讨超声引导下罗哌卡因复合布托啡诺腰丛-骶丛神经阻滞对人工股骨头置换术患者术后疼痛的影响。方法选取2020年1月至2021年12月于贵溪市中医院就诊的68例人工股骨头置换术患者作为研究对象,随机分为联合组与对照组,每组34例。患者于超声引导下行腰丛-骶丛神经阻滞,联合组给予0.5%罗哌卡因30ml+布托啡诺1μg/kg,对照组给予0.5%罗哌卡因30ml。比较两组麻醉起效和运动神经阻滞起效和持续时间、镇静效果(Ramsay评分)、术后24h内疼痛程度[视觉模拟评分法(visualanaloguescale,VAS)评分]、术后镇痛泵使用情况及术中不良反应发生情况。结果联合组麻醉起效和运动神经阻滞起效时间均短于对照组,镇痛持续和运动阻滞持续时间均长于对照组,差异有统计学意义(P<0.05);两组追加静脉镇痛药占比比较差异无统计学意义。阻滞起效后10min(T1)~术后(T4),联合组Ramsay评分均高于对照组,差异有统计学意义(P<0.05)。治疗后4、6、8、16、24h,联合组VAS评分均低于对照组,差异有统计学意义(P<0.05)。联合组术后镇痛泵首次按压时间长于对照组,术后1d内镇痛泵使用量和追加镇痛次数均少于对照组,差异有统计学意义(P<0.05)。联合组麻醉不良反应发生率为2.94%,对照组为5.88%,两组比较差异无统计学意义。结论在腰丛-骶丛神经阻滞中,超声引导下罗哌卡因复合布托啡诺麻醉效果显著,具有较好的镇静、镇痛作用,可降低不良反应发生率,值得临床推广应用。Objective To explore the effects of ultrasound-guided ropivacaine combined with butorphanol for lumbo-sacral plexus block on pain in patients after artificial femoral head replacement.Methods A total of 68 patients undergoing artificial femoral head replacement in Guixi Hospital of Traditional Chinese Medicine from January 2020 and December 2021 were enrolled as the research subjects,and they were randomly divided into the combined group and the control group,with 34 cases in each group.The combined group was given 0.5%ropivacaine(30 ml)+1μg/kg butorpha-nol,while the control group was given 0.5%ropivacaine(30 ml)for ultrasound-guided lumbo-sacral plexus block.The onset time and duration of an-esthesia and motor nerve block,sedation effect(Ramsay score),pain degree(visual analogue scale[VAS])within 24 h after surgery,postoperative use of analgesic pump and occurrence of intraoperative adverse reactions were compared between the two groups.Results The onset time of anes-thesia and motor nerve block in the combined group was shorter than that in the control group,and duration of analgesia and motor block was longer than that in the control group,and the differences were statistically significant(P<0.05);there was no significant difference in supplementary rate of intravenous analgesics between the two groups.From 10 min after block onset(T1)to after surgery(T4),Ramsay scores in the combined group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).At 4,6,8,16 and 24 h after treatment,VAS scores in the combined group were lower than those in the control group,and the difference was statistically significant(P<0.05).The postoperative first compression time of analgesic pump in the combined group was longer than that in the control group,use frequency of analge-sic pump and supplementary frequency of intravenous analgesics within 1 d after surgery were lower than those in the control group,and the differ-ence was statistically significant(P<0.05).The inc

关 键 词：超声 罗哌卡因 布托啡诺 腰丛-骶丛神经阻滞 人工股骨头置换术 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]