Paauwe J J, Thomassen B J, Weterings J, van Rossum E, Ausems M E
Department of Anaesthesiology, Maasland Hospital, Orbis medisch en Zorgconcern, MB, Sittard, the Netherlands.
Anaesthesia. 2008 Sep;63(9):948-53. doi: 10.1111/j.1365-2044.2008.05538.x. Epub 2008 Jun 6.
Femoral nerve blockade is recommended for analgesia following total knee arthroplasty. Following implementation of this type of postoperative analgesia in our hospital we found that active mobilization the day after surgery, may be difficult due to insufficient quadriceps muscle strength. We therefore designed a pilot study comparing the effect of ropivacaine 0.1%, 0.05% or 0.025% on the patient's postoperative rehabilitation and analgesia. Three groups of 12 patients received bolus doses of ropivacaine via their femoral nerve catheters for postoperative analgesia. The ability to actively mobilize, quadriceps muscle strength, pain VAS-scores and patient's satisfaction were measured during in the first three postoperative days. There were no significant differences in the patient's ability to actively mobilize and the pain VAS-scores. The overall satisfaction of the patients with the pain treatment was significantly better (p = 0.049) in the 0.1% compared with the 0.025% group. This pilot-study demonstrated no advantage associated with the use of a ropivacaine concentration less than 0.1%.
全膝关节置换术后推荐采用股神经阻滞进行镇痛。在我院实施此类术后镇痛后,我们发现术后第一天主动活动可能因股四头肌力量不足而困难。因此,我们设计了一项前瞻性研究,比较0.1%、0.05%或0.025%罗哌卡因对患者术后康复和镇痛的效果。三组患者各12例,通过股神经导管给予负荷剂量的罗哌卡因用于术后镇痛。在术后前三天测量主动活动能力、股四头肌力量、疼痛视觉模拟评分(VAS)及患者满意度。患者的主动活动能力和疼痛VAS评分无显著差异。与0.025%组相比,0.1%组患者对疼痛治疗的总体满意度显著更高(p = 0.049)。这项前瞻性研究表明,使用浓度低于0.1%的罗哌卡因并无优势。