摘要
目的观察罗哌卡因与罗哌卡因复合舒芬太尼或地佐辛连续股神经阻滞(FNB)在全膝关节置换术(TKA)术后镇痛中的效果。方法择期行单侧TKA患者60例,采用统一麻醉和手术方案,术后FNB自控镇痛48h,持续剂量2ml/h,总量100ml。随机将患者均分为三组:罗哌卡因组(R组):0.225%罗哌卡因;罗哌卡因复合地佐辛组(D组):0.15%罗哌卡因含地佐辛10 mg;罗哌卡因复合舒芬太尼组(S组):0.15%罗哌卡因含舒芬太尼1μg/kg。记录三组患者术后1、3及7d静息状态下VAS(RVAS)评分、主动功能锻炼时VAS(AVAS)评分和被动功能锻炼时VAS(PVAS)评分;记录其他镇痛药物用量、不良事件发生情况。结果术后1、3、7d三组患者RVAS评分,术后1、7d的AVAS评分和术后1d的PVAS评分明显低于术前(P<0.05);术后3d,S组与D组RVAS评分明显高于R组(P<0.05)。三组术后恶心呕吐及谵妄发生率差异无统计学意义。结论罗哌卡因复合舒芬太尼或地佐辛用于FNB,可提供良好的TKA术后镇痛效果,且不增加不良反应;但0.15%罗哌卡因复合舒芬太尼或地佐辛不及0.225%罗哌卡因镇痛维持时间长,复合地佐辛这一现象更明显。
Objective To observe the analgesia effects of ropivacaine with sufentanil or dezocine on continuous femoral nerve block（FNB）after total knee arthroplasty（TKA）.Methods Sixty undergoing selective unilateral TKA patients,received postoperative analgesia with continuous FNB for48 hours,were randomly divided into three groups according to the drug formulations：0.225%ropivacaine（group R）,0.15% ropivacaine mixed dezocine 10 mg（group D）,and 0.15% ropivacaine mixed sufentanil 1μg/kg（group S）;the visual analogue scale（VAS）in resting state（RVAS）,active functional exercise state（AVAS）,passive functional exercise state（PVAS）were recorded at1,3,7dafter surgery.The other analgesics dosage and the incidence of nausea and vomiting and other complications were recorded.Results Compared with preoperative state,the RVAS scores in three groups were significantly lower at 1,3,7dafter surgery,the PVAS scores were significantly lower at7 dafter surgery（P〈0.05）.Compared with group R,the RVAS scores were significantly higher either in groups S or D at the 3dpostoperatively（P〈0.05）.There were no significantly difference in adverse reaction among three groups.Conclusion Ropivacaine combined with sufentanil or dezocine through continuous FNB can provide a effectual postoperative analgesia in TKA patients without an increase in adverse events.But compared to 0.225% ropivacaine,0.15% ropivacaine with sufentanil or dezocine may not keep a longer analgesia duration,this is more obvious observed in dezocine group.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2016年第3期258-261,共4页
Journal of Clinical Anesthesiology
基金
宁夏医科大学校级项目(XM201444)
关键词
股神经阻滞
全膝关节置换
地佐辛
舒芬太尼
镇痛
Femoral nerve block
Total knee arthroplasty
Dezocine
Sufentanil
Analgesia
