摘要
[目的]研究全膝关节置换(total knee arthroplasty,TKA)术中关节周围注射罗哌卡因、酮洛酸氨丁三醇、肾上腺素混合药物,联合术后关节腔内注射罗哌卡因、酮洛酸氨丁三醇对TKA的镇痛效果、术后康复的影响及副作用。[方法]选择在本院行单侧TKA的50例患者随机分为两组,研究组术中将罗哌卡因、酮洛酸氨丁三醇、肾上腺素的混合液注射在膝关节周围,术后48h拔除引流管后,关节腔内注入罗哌卡因、酮洛酸氨丁三醇。对照组术中、术后均给予相同剂量的生理盐水作为对照。记录视觉模拟评分(VAS)、Rameasay镇静评分,CPM膝关节活动度及副作用,应用统计软件SPSS13.0进行统计学分析。[结果]研究组术后6、12、24h,第3、4d的VAS评分均低于对照组,(t=3.49～2.34,P<0.05),第2d时VAS评分无差别(t=1.99,P>0.05),CPM膝关节活动度在术后2～6d高于对照组(t=3.030～2.112,P<0.05),而在第7d以后活动度无差别(t=1.997～2.020,P>0.05)。两组副作用无差别(x2值1.657a,P>0.05)。[结论]TKA术中关节周围注药联合术后关节腔内注药可在术后早期减轻疼痛、改善关节活动度、促进康复,且不会增加副作用。
[ Objective] To investigate the analgesia effect, the influence on rehabilitation and side effect of ropivacaine, ketorolac tromethamine, epinephrine during the total knee arthroplsaty （TKA） combined with intra -articular injection of ropivacaine and ketorolac tromethamine after TKA. [ Methods] Fifty patients who underwent unilateral TKA from November 2007 to July 2008 were randomly divided into two groups. The study group received periarticnlar injection of ropivacaine , ketorolac tromethamine and epinephrine at operation combined with inrta - articular injection of ropivacaine and ketorolac tromethamine after TKA. The control group received the same dosage of normal saline at operation and after operation. VAS, Rameasay sedation score , the range of CPM exercises of the knee and side effect were recorded, respectively. SPSS 13.0 was used to analyze the data. [ Results] At 6, 12, 24 hour, 3 and 4 days , VAS in study group was lower than that in control group （t = 3.49 2.34, P 〈 0. 05）, but there was no difference at 2 days between the two groups （ t = 1.99, P 〉 0. 05 ） . The range of CPM exercises of the knee was higher in the study group that in than in the control group at 2 - 6 days （ t = 3.030 - 2. 112, P 〈 0. 05）, but no difference was noted at 7 days （ t = 1. 997 - 2. 020, P 〉 0. 05） . The incidence of side effect was not different between 2 groups （x^2 = 1. 657 °, P 〉 0. 05 ） . [ Conclusion ] Periarticular drug injection during TKA and intra - articular drug injection after operation can relieve pain early after TKA, improve the range of motion of the knee and rehabilitation, no further side effect has been noted.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2009年第9期654-657,共4页
Orthopedic Journal of China
关键词
人工假体
全膝关节
局部注药
镇痛
artificial joint
total knee arthroplasty
local drug injection
analgesia
