右美托咪定复合罗哌卡因股神经阻滞对髋关节置换术后镇痛的影响

doi:10.3969/j.issn.2095-378X.2021.01.017

摘要/Abstract

摘要： 目的探究右美托咪定复合罗哌卡因股神经阻滞对髋关节置换术（THR）后镇痛效果的影响。方法选择2018年9月—2020年9月开展THR患者160例为研究对象,采用数字奇偶法将患者分为对照组（奇数,80例）与观察组（偶数,80例）,两组术后均接受连续股神经阻滞镇痛,背景剂量8 mL/h,冲击剂量4 mL/30 min;对照组配方为0.2%罗哌卡因,观察组配方为1 μg/mL右美托咪定复合0.1%罗哌卡因。比较两组患者术后吗啡用量,术后6 h、12 h、24 h视觉模拟疼痛评分（VAS）,术后1 d、7 d匹兹堡睡眠指数（PSQI）及不良反应发生情况。结果观察组吗啡用量低于对照组,术后6 h、12 h VSA评分低于对照组,术后1 d、7 d PSQI评分低于对照组,并发症发生率低于对照组,差异有统计学意义（P<0.05）。结论右美托咪定复合罗哌卡因股神经阻滞应用于THR术后镇痛效果显著,可减少吗啡用量,降低术后疼痛,提升睡眠质量,降低术后并发症。

关键词: 右美托咪定, 罗哌卡因, 股神经阻滞, 髋关节置换术, 镇痛, 匹兹堡睡眠指数

Abstract: Objective To investigate the effect of dexmedetomidine combined with ropivacaine femoral nerve block on postoperative analgesia after total hip replacement （THR）. Methods A total of 160 patients with THR admitted from September 2018 to September 2020 were selected as study subjects. The patients were divided into a control group （odd number, 80 cases） and an observation group （even number, 80 cases） by digital odd-even method. Both groups received continuous femoral nerve block for analgesia after surgery, with a background dose of 8 mL/h and a shock dose of 4 mL per 30 min. The control group was prescribed 0.2% ropivacaine and the observation group was prescribed 1 μg/mL dexmedetomidine combined with 0.1% ropivacaine. The morphine consumption, Visual Analogue Scale （VAS） score at postoperative 6 h, 12 h, and 24 h, Pittsburgh Sleep Quality Index （PSQI） at postoperative 1 d and 7 d, and adverse reactions were compared between the two groups. Results The morphine consumption, the VAS scores 6 h and 12 h after operation, the PSQIs 1 d and 7 d after operation, and the incidence of complications of the observation group were significantly lower than those of the control group （P<0.05）. Conclusion Dexmedetomidine combined with ropivacaine femoral nerve block has a significant analgesic effect after THR operation, and it can reduce morphine dosage and postoperative pain, improve sleep quality, and reduce postoperative complications.

Key words: Dexmedetomidine, Ropivacaine, Femoral nerve block, Total hip replacement, Analgesia, Pittsburgh Sleep Quality Index

中图分类号:

R614

陈竞, 吴穗平, 蔡宜良, 陈家趁, 谢葵山. 右美托咪定复合罗哌卡因股神经阻滞对髋关节置换术后镇痛的影响[J]. 外科研究与新技术, 2021, 10(1): 61-63.

CHEN Jing, WU Suiping, CAI Yiliang, CHEN Jiachen, XIE Kuishan. Effect of dexmedetomidine combined with ropivacaine femoral nerve block on analgesia after total hip replacement[J]. Surgical Research and New Technique, 2021, 10(1): 61-63.

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