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[不同背景容量罗哌卡因在跟骨手术患者胫神经连续阻滞中的术后镇痛效果]

[Postoperative analgesia effect of different background volumes of ropivacaine in continuous tibial nerve block in patients with calcaneal surgery].

作者信息

Yi J, Xu L, Lin H H

机构信息

Department of Anesthesia, Beijing Jishuitan Hospital, Beijing 100035, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Apr 18;48(2):283-6.

Abstract

OBJECTIVE

To observe the clinical effect of different background volumes of ropivacaine in continuous tibial nerve block of postoperative analgesia after calcaneal surgery.

METHODS

This study was a prospective, randomized, controlled study. Sixty cases of calcaneal visual analogue scale (ASA) I or II undergoing elective surgery were selected and randomly assigned to two groups, thirty cases in each group. The patients received popliteal fossa posterior tibial nerve block using ultrasound guided. The continuous stimulation catheter was inserted after successful position and the 0.2% ropivacaine was injected. The background volumes of the A and B groups were 5 mL/h and 3.2 mL/h. The VAS score, the sensory block and motor block of tibial nerve and common peroneal nerve, and the satisfaction of the patients at h 12, h 24 and h 48 were recorded after catheter insertion.

RESULTS

The VAS scores at the three time points (h 12, h 24 and h 48) on the two groups of the patients were compared, and the difference was not statistically significant (P > 0.05). The difference of the sensory block and the motor block of the tibial nerve at the three time points (h 12, h 24 and h 48) on the two groups of the patients were also compared, and the difference was not statistically significant (P> 0.05). The difference of the sensory block and the motor block of common peroneal nerve at h 48 hs was statistically significant, group A was higher than the group B (P< 0.05). The difference of the patient satisfaction at the three time points (h 12, h 24 and h 48) on the two groups was not statistically significant (P> 0.05).

CONCLUSION

The use of 0.2% ropivacaine with the background volume of 3.2 mL/h in continuous tibial nerve block can provide good analgesia and reduce the incidence of the sensory block and motor block of the common peroneal nerve.

摘要

目的

观察不同背景容量的罗哌卡因在跟骨手术后胫神经连续阻滞镇痛中的临床效果。

方法

本研究为前瞻性、随机、对照研究。选取60例择期行跟骨手术的美国麻醉医师协会(ASA)Ⅰ或Ⅱ级患者,随机分为两组,每组30例。患者采用超声引导下行腘窝胫神经阻滞。定位成功后插入连续刺激导管,注入0.2%罗哌卡因。A组和B组的背景容量分别为5 mL/h和3.2 mL/h。记录置管后12小时、24小时和48小时患者的视觉模拟评分(VAS)、胫神经和腓总神经的感觉阻滞及运动阻滞情况,以及患者满意度。

结果

比较两组患者在三个时间点(12小时、24小时和48小时)的VAS评分,差异无统计学意义(P>0.05)。比较两组患者在三个时间点(12小时、24小时和48小时)胫神经的感觉阻滞及运动阻滞情况,差异无统计学意义(P>0.05)。48小时时两组患者腓总神经的感觉阻滞及运动阻滞差异有统计学意义,A组高于B组(P<0.05)。两组患者在三个时间点(12小时、24小时和48小时)的患者满意度差异无统计学意义(P>0.05)。

结论

在胫神经连续阻滞中使用背景容量为3.2 mL/h的0.2%罗哌卡因可提供良好的镇痛效果,并降低腓总神经感觉阻滞和运动阻滞的发生率。

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