Chen Yong-Cheng, Zan Qiang, Fu Yu-Meng, Cao Shi-Hang, Zhi Li-Qiang
Shaanxi Universitv of Chinese Medicine, Xianyang 712046, Shaanxi, China; Department of Joint Surgery, Xi'an Honghui Hospital, Xi'an 710054, Shaanxi, China.
Department of Orthopaedics, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, Shaanxi, China.
Zhongguo Gu Shang. 2025 Jul 25;38(7):693-7. doi: 10.12200/j.issn.1003-0034.20230989.
To compare the effects of different concentrations of ropivacaine femoral nerve block on postoperative pain and early exercise fllowing total knee arthroplasty(TKA).
A total of 90 patients who underwent primary TKA between September 2022 and February 2023 were consecutively enrolled in this study. The cohort consisted of 34 males and 56 females, with a mean age of (66.66±7.03) years old. According to different concentrations of ropivacaine, patients were divided into 0.1% group, 0.2% group and 0.4% group, with 30 patients in each group. The age, gender, body mass index(BMI), American Society of Aneshesiologists(ASA) grade, operation time, anesthesia time, tourniquet using time, Post Anesthesia care unit(PACU) stay duration, ambulation time, first reaching to Bromage 0 grade time, visual analogue scale(VAS), hospitalization period and postoperative adverse reactions were compared among the three groups.
All 90 patients were followed up for an average of (31.56±5.62) days, and no postoperative adverse reactions occurred. There were no significant differences among the three groups in terms of age, gender, BMI, ASA classification, operation time, anesthesia time, tourniquet application time, PACU stay duration, and hospitalization period (>0.05). Significant differences were observed in VAS scores at 1, 2, 4, 6, and 12 hours post-operation among the three groups (<0.05). Additionally, significant variations were noted in ambulation time and the first reaching to Bromage level 0 time among the three groups (<0.05). In terms of postoperative pain, the VAS of the 0.1% group at 1, 2, 4, 6, and 12 hours after surgery(1.93±0.52), (2.57±0.77), (3.10±0.71), (3.10±0.71), (3.07±0.45) points were higher than those of the 0.4% group (1.57±0.50), (2.10±0.55), (2.23±0.57), (2.47±0.73), (2.50±0.57) points, and the differences were statistically significant (<0.05);the VAS of the 0.1% group at 4, 6, and 12 hours after surgery were higher than those of the 0.2% group (2.43±0.57), (2.53±0.57), (2.63±0.56) points, and the differences were statistically significant (<0.05);there was no statistically significant difference in VAS between the 0.2% group and the 0.4% group (>0.05). In terms of early postoperative mobility, the time to ambulation time (8.30±2.76) h and the time to achieve the first Bromage grade 0 (6.13±2.18) h were significantly prolonged in the 0.4% group compared to both the 0.1% group (6.93±1.76) h, (4.17±1.18) h and the 0.2% group (6.53±1.59) h, (4.87±1.53) h. No statistically significant differences were observed between the 0.1% and 0.2% groups (>0.05).
0.2% ropivacaine femoral nerve block can effectively reduce postoperative pain after TKA and can perform early exercise earlier.
比较不同浓度罗哌卡因股神经阻滞对全膝关节置换术（TKA）后疼痛及早期活动的影响。
连续纳入2022年9月至2023年2月期间行初次TKA的90例患者。该队列包括34例男性和56例女性，平均年龄为（66.66±7.03）岁。根据罗哌卡因浓度不同，将患者分为0.1%组、0.2%组和0.4%组，每组30例。比较三组患者的年龄、性别、体重指数（BMI）、美国麻醉医师协会（ASA）分级、手术时间、麻醉时间、止血带使用时间、麻醉后恢复室（PACU）停留时间、行走时间、首次达到布罗玛0级时间、视觉模拟评分（VAS）、住院时间及术后不良反应。
90例患者均获随访，平均随访时间为（31.56±5.62）天，未发生术后不良反应。三组患者在年龄、性别、BMI、ASA分级、手术时间、麻醉时间、止血带使用时间、PACU停留时间及住院时间方面差异均无统计学意义（>0.05）。三组患者术后1、2、4、6及12小时的VAS评分差异有统计学意义（<0.05）。此外，三组患者在行走时间及首次达到布罗玛0级时间方面差异也有统计学意义（<0.05）。术后疼痛方面，0.1%组术后1、2、4、6及12小时的VAS评分（1.93±0.52）、（2.57±0.77）、（3.10±0.71）、（3.10±0.71）、（3.07±0.45）分高于0.4%组（1.57±0.50）、（2.10±0.55）、（2.23±0.57）、（2.47±0.73）、（2.50±0.57）分，差异有统计学意义（<0.05）；0.1%组术后4、6及12小时的VAS评分高于0.2%组（2.43±0.57）、（2.53±0.57）、（2.63±0.56）分，差异有统计学意义（<0.05）；0.2%组与0.4%组VAS评分差异无统计学意义（>0.05）。术后早期活动方面，0.4%组的行走时间（8.30±2.76）小时及首次达到布罗玛0级时间（6.13±2.18）小时较0.1%组（6.93±1.76）小时、（4.17±1.18）小时及0.2%组（6.53±1.59）小时、（4.87±1.53）小时均显著延长。0.1%组与0.2%组之间差异无统计学意义（>0.05）。
0.2%罗哌卡因股神经阻滞可有效减轻TKA术后疼痛，并能更早进行早期活动。
