Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
Department of Emergency, the First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020938122. doi: 10.1177/2309499020938122.
Local anesthesia (LA) is widely used in knee arthroscopic surgery but not in ankle arthroscopy.
To understand the effectiveness and safety of LA combined with ropivacaine in pain control for ankle arthroscopy.
Retrospective cohort.
We retrospectively collected data for patients who underwent ankle arthroscopy from April 2012 to April 2017. Patients were grouped by anesthesia method: LA, LA with ropivacaine (LA+R), spinal anesthesia (SA), and SA with ropivacaine (SA+R). Intra- and postoperative visual analog scale (VAS) scores, complications, doses of supplemental pain medication, hospitalization cost and duration, and satisfaction with pain control during hospitalization were analyzed.
The study included 276 patients (LA: 93; LA+R: 124; SA: 31; SA+R: 28). The LA and LA+R groups had significantly higher intraoperative VAS scores (LA vs. SA, = 0.001; LA vs. SA+R, = 0.002; LA+R vs. SA, = 0.00; LA+R vs. SA+R, = 0.00), but fewer complications, than the SA and SA+R groups. The LA+R and SA+R groups had significantly better outcomes for postoperative pain control (LA vs. LA+R, = 0.01; LA vs. SA+R, 0.01; SA vs. SA+R, = 0.01; SA vs. LA+R, 0.03) and required less supplemental pain medication. Hospitalization cost was lower and duration shorter in the LA and LA+R groups than in the SA and SA+R groups. There was no significant difference in satisfaction among the four groups.
This was a single-center retrospective and relatively short-term study.
LA+R which could be safely applied in ankle arthroscopy provided satisfactory pain control, reduced postoperative pain intensity, fewer complications, shorter hospital stay, and good cost-effectiveness. It can be safely applied in ankle arthroscopy for the specific patients with ankle osteoarthritis.
局部麻醉（LA）广泛应用于膝关节关节镜手术，但不适用于踝关节关节镜手术。
了解 LA 联合罗哌卡因在踝关节镜检查中控制疼痛的效果和安全性。
回顾性队列研究。
我们回顾性收集了 2012 年 4 月至 2017 年 4 月期间接受踝关节镜检查的患者数据。根据麻醉方法将患者分为以下几组：LA 组、LA 联合罗哌卡因（LA+R）组、椎管内麻醉（SA）组和 SA 联合罗哌卡因（SA+R）组。分析术中、术后视觉模拟评分（VAS）、并发症、辅助止痛药物剂量、住院费用和时间以及住院期间疼痛控制满意度。
本研究共纳入 276 例患者（LA 组 93 例，LA+R 组 124 例，SA 组 31 例，SA+R 组 28 例）。LA 组和 LA+R 组的术中 VAS 评分明显高于 SA 组和 SA+R 组（LA 与 SA 比较， = 0.001；LA 与 SA+R 比较， = 0.002；LA+R 与 SA 比较， = 0.000；LA+R 与 SA+R 比较， = 0.000），但并发症较少。LA+R 组和 SA+R 组术后疼痛控制效果明显更好（LA 与 LA+R 比较， = 0.01；LA 与 SA+R 比较， 0.01；SA 与 SA+R 比较， = 0.01；SA 与 LA+R 比较， 0.03），需要的辅助止痛药物较少。LA 组和 LA+R 组的住院费用较低，住院时间较短。四组患者满意度无显著差异。
这是一项单中心回顾性研究，且随访时间相对较短。
LA+R 可安全应用于踝关节镜检查，能提供满意的疼痛控制效果，减轻术后疼痛强度，减少并发症，缩短住院时间，具有良好的成本效益，可安全应用于特定的踝关节骨关节炎患者。
