摘要
目的:观察罗哌卡因术后镇痛用于老年人工股骨头置换术后早期功能锻炼的效果和安全性。方法:选择期单侧人工股骨头置换术高龄患者120例,行腰硬联合麻醉,术后镇痛随机分为3组:A组为安慰剂组,B组为0.75%布比卡因75 mg+90mL0.9%的氯化钠注射液组,C组为1%罗哌卡因150 mg+85 mL0.9%的氯化钠注射液组,观察并记录术后3组患者不同时点的视觉模拟评分(VAS),开启PCA泵患者按压次数(D),患者的生命体征及不良反应,术后2周内并发症发生率及术后6个月髋关节功能的评价。结果:与安慰剂A组比较,术后B组和C组的VAS明显低于A组(P<0.05),B组与C组无明显差异(P>0.05);术后B组和C组的并发症少于A组(P<0.05),C组术后6个月髋关节功能优良率明显高于A组(P<0.05);与B组比较,C组术后并发症减少。结论:小剂量的罗哌卡因对这类患者镇痛效果好,术后肌力恢复快,术后并发症少,应用于老年全髋关节置换术的早期功能锻炼安全、有效。
OBJECTIVE To observe the effect and safety of ropivacaine in patient-controlled analgesia for the aged patients in artificial femoral head replacement in early functional exercise. METHODS 120 aged patients who would receive unilateral elective prosthetic femoral head replacement were divided randomly into three groups： group A was placebo group （n = 40） ： the pump was filled with 100mL physiological saline （n = 40） ,group B ： the pump was filled with 0. 75% bupivacaine 75 mg and 90 mL, physiological saline （n = 40） ;group C： the pump was filled with 1 % ropivacaine 75 mg and 90 mL physiological saline （n = 40）, received simple lumbar anesthesia. The visual analogue scale in the different time points, the press times after open PCVA, the patients＇ vital signs and postoperative adverse reaction,the complications two weeks after operation were recorded; and e valuated the hip function six weeks after operation. RESULTS Compared with the placebo group A ,the VAS of group B and C were significantly lower （P〈0.05）, there was no difference between group B and C （P〉0. 05 ） ;the complications of postoperation and two weeks after operation of group B and C were decreased （P〈0. 05）, Good rates of hip function were obviously higher （P〈0. 05） ;compared with the group B, the complications two weeks after operation of group C were decreased （P〈 0. 05）. CONCLUSION Low-dose ropivacaine used in aged patient for patient controlled analgesia is effective and safety. It is benefit for early functional exercise of artificial femoral head replacement; also the limb recovered quickly.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2012年第10期796-799,共4页
Chinese Journal of Hospital Pharmacy
关键词
罗哌卡因
高龄
术后镇痛
人工股骨头置换术
早期功能锻炼
ropivacaine
aged
patient controlled analgesia
artificial femoral head replacement
early functional exercise
