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超声引导下连续股神经阻滞复合低浓度罗哌卡因用于老年膝关节置换术后镇痛。

Ultrasound-Guided Continuous Femoral Nerve Block with Dexmedetomidine Combined with Low Concentrations of Ropivacaine for Postoperative Analgesia in Elderly Knee Arthroplasty.

机构信息

Department of Anesthesiology, The Second Hospital of Shanxi Medical University, Taiyuan, China.

Department of Anesthesiology, The Affiliated Hospital of Yan'an University, Yan'an, China.

出版信息

Med Princ Pract. 2019;28(5):457-462. doi: 10.1159/000500261. Epub 2019 Apr 16.

Abstract

OBJECTIVES

This study aims to investigate the clinical effect of dexmedetomidine (DEX) combined with low concentrations of ropivacaine in ultrasound-guided continuous fem-oral nerve block for postoperative analgesia in elderly patients with total knee arthroplasty (TKA).

MATERIALS AND METHODS

Patients were divided into three groups: group C, group D1, and group D2. For postoperative analgesia, patients in group C were given 0.15% ropivacaine, patients in group D1 were given 0.15% ropivacaine + 0.02 μg × kg-1 × h-1 DEX, and patients in group D2 were given 0.15% ropivacaine + 0.05 μg × kg-1 × h-1 DEX. The visual analogue scores in the resting state, active state (AVAS), and passive functional exercise state (PVAS), degree of joint bending, and Ramsay scores were recorded.

RESULTS

The Ramsay scores were significantly higher, AVAS scores were significantly lower, PVAS scores were significantly decreased, the degree of joint bending was significantly higher, and the time to the first postoperative ambulation was shorter in groups D1 and D2 than group C. Furthermore, the time to the first postoperative ambulation was shorter in group D2 than in group D1, patients in groups D1 and D2 were more satisfied than patients in group C, and patients in group D2 were more satisfied than patients in group D1.

CONCLUSION

The protocol of 0.05 μg × kg-1 × h-1 of DEX combined with 0.15% ro-pivacaine in ultrasound-guided continuous femoral nerve block for postoperative analgesia in elderly patients with TKA provides a better analgesic effect than without DEX performance.

UNLABELLED

X.-Y.Z. and E.-F.Z. have contributed equally to this research.

摘要

目的

本研究旨在探讨右美托咪定(DEX)联合低浓度罗哌卡因在超声引导下连续股神经阻滞用于老年全膝关节置换术(TKA)患者术后镇痛的临床效果。

材料与方法

患者分为三组:C 组、D1 组和 D2 组。C 组给予 0.15%罗哌卡因,D1 组给予 0.15%罗哌卡因+0.02μg×kg-1×h-1DEX,D2 组给予 0.15%罗哌卡因+0.05μg×kg-1×h-1DEX。记录患者静息状态、主动状态(AVAS)、被动功能运动状态(PVAS)时的视觉模拟评分(VAS)、关节弯曲程度和 Ramsay 评分。

结果

D1 组和 D2 组 Ramsay 评分较高,AVAS 评分较低,PVAS 评分较低,关节弯曲程度较高,首次术后下床活动时间较短。与 D1 组相比,D2 组首次术后下床活动时间较短,D1 组和 D2 组患者满意度高于 C 组,D2 组患者满意度高于 D1 组。

结论

超声引导下连续股神经阻滞中加入 0.05μg×kg-1×h-1DEX 可提高 0.15%罗哌卡因用于老年 TKA 患者术后镇痛的效果,优于未加用 DEX 的方案。

Z.-Y.X. 和 Z.-F.E. 对本研究贡献相同。

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