摘要
目的分析右美托咪定复合罗哌卡因连续收肌管阻滞(ACB)镇痛在全膝关节置换(TKA)术后患者康复中的应用效果.方法选取2021年1月—2023年1月于常熟市第一人民医院接受TKA手术的90例患者为研究对象,采用随机数字表法将其分为对照组及观察组,每组45例.对照组ACB镇痛采用0.375%罗哌卡因,观察组ACB镇痛采用1.0μg/mL右美托咪定复合0.375%罗哌卡因.比较两组患者术后4、8、12、24、48 h静息态及运动态的疼痛视觉模拟评分(VAS)、术后首次按压病人自控镇痛泵(PCA)时间、按压PCA次数、氟比洛芬酯用量、首次下床时间、膝关节屈曲至90°时间及不良反应发生情况.结果术后4、8、12、24、48 h,观察组的静息态及运动态VAS评分均低于对照组,组间差异有统计学意义(P<0.05).观察组的术后首次按压PCA时间长于对照组,按压PCA次数及氟比洛芬酯用量均少于对照组,组间差异有统计学意义(P<0.05).观察组的术后首次下床时间、膝关节屈曲至90°的时间分别为(40.39±4.26)h、(6.39±1.42)d,均短于对照组的(59.54±7.79)h、(8.37±1.59)d,组间差异有统计学意义(P<0.05).两组的各项不良反应发生率比较,组间差异无统计学意义(P>0.05).结论右美托咪定复合罗哌卡因ACB镇痛的效果好,可促使患者术后早期下床,有助于其术后康复.
Objective To analyze the effect of dexmedetomidine combined with ropivacaine continuous adductor block analgesia on rehabilitation after total knee arthroplasty(TKA).Methods 90 patients receiving TKA surgery in the First People's Hospital of Changshu City from January 2021 to January 2023 were selected as the research objects and were divided into a control group and an observation group by random number table method,with 45 cases in each group.The control group was treated with 0.375%ropivacaine for ACB analgesia,while the observation group was treated with 1.0μg/mL dexmedetomidine combined with 0.375%ropivacaine for ACB analgesia.The pain Aisual Analogue Scores(VAS)at 4,8,12,24 and 48 h after surgery,the time of first patient-controlled analgesia(PCA)pump,the number of PCA compressions,the dosage of flurbiprofen axidate,the time of first getting out of bed,the time of knee flexion to 90°and the occurrence of adverse reactions were compared between the two groups.Results At 4,8,12,24 and 48 h after surgery,the VAS scores of resting state and activity state in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).The first time of PCA compression in the observation group was longer than that in the control group,and the times of PCA compression and the dosage of flurbiprofen ester were less than those in the control group,and the differences between the groups were statistically significant(P<0.05).The first time of getting out of bed and the time of knee flexage to 90°in the observation group were(40.39±4.26)h and(6.39±1.42)d,respectively,which were shorter than(59.54±7.79)h and(8.37±1.59)d in the control group,and the differences between the groups were statistically significant(P<0.05).There were no significant differences in the incidences of adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine combined with ropivacaine ACB has a good analgesic effect,which can promote patients to get out of bed early after surgery and contribute to postoperative rehabilitation.
作者
卢慕婷
芦秀云
陈玲玲
管忍
LU Muting;LU Xiuyun;CHEN Lingling;GUAN Ren(Department of Anesthesiology,The First People's Hospital of Changshu City,Suzhou Jiangsu,215500,China)
出处
《反射疗法与康复医学》
2024年第6期157-160,共4页
Reflexology And Rehabilitation Medicine
关键词
全膝关节置换术
右美托咪定
罗哌卡因
连续收肌管阻滞
康复
Total Knee Replacement
Dexmedetomidine
Ropivacaine
Continuous adductor Canal Block
Rehabilitation
