摘要
目的:探讨局部浸润镇痛联合地佐辛自控静脉镇痛在单侧全膝关节置换中的镇痛效果。方法:择期行单侧全膝关节置换手术患者60例,ASAⅠ或Ⅱ级,随机数字表法分为局部浸润镇痛联合地佐辛静脉镇痛组(LD组)和地佐辛静脉镇痛组(D组),每组30例。所有患者采用腰硬联合麻醉,LD组于术中假体安放完毕后行切口局部浸润镇痛(3.0 g/L罗哌卡因50 ml+肾上腺素0.05 mg)及术后地佐辛0.6mg/kg静脉镇痛,D组术毕行地佐辛0.8 mg/kg静脉镇痛。分别记录患者术后2 h(T_1)、4 h(T_2)、8 h(T_3)、12 h(T_4)静息和活动疼痛视觉模拟评分(VAS),Ramsay镇静评分,镇痛泵有效按压次数,记录患者不良反应。结果:LD组术后T_2活动VAS评分低于D组(P<0.05),术后T_3、T_4静息和活动VAS评分明显低于D组(P<0.01),48h镇痛泵有效按压次数少于D组(P<0.05),LD组头晕、恶心呕吐发生率低于D组(P<0.05)。结论:局部浸润镇痛联合地佐辛自控静脉镇痛组综合镇痛质量高,不良反应少,可适合单侧全膝置换。
Objective:To investigate the efficiency of local infiltration analgesia combined with patientcontrolled intravenous dezocine analgesia in unilateral total knee arthroplasty.Methods:Sixty patients undergoing unilateral total knee arthroplasty(ASA I or II)were divided into the local infiltration analgesia combined with intravenous dezocine analgesia group(LD group)and intravenous dezocine analgesia group(D Group)by random digit table(n=30 each).All patients underwent combined spinal-epidural anesthesia.After placement of the prosthesis,the LD group received local infiltration analgesia(3.0 g/L ropivacaine 50 ml+adrenaline 0.05 mg)of the incision wound and postoperative intravenous dezocine analgesia(0.6 mg/kg),whereas the D group was given intravenous dezocine analgesia(0.8 mg/kg).The patients were recorded at postoperative 2h(T1),4h(T2),8h(T3),12h(T4)for resting and motion pain based on visual analogue scale(VAS),Ramsay sedation score,effective compression of the analgesic pump,and adverse reactions.Results:Compared with the D group,LD group had lower VAS score of motion pain at T2(P<0.05),and remarkably lower VAS scores of resting and motion pain at T3 and T4(P<0.01),and less analgesic pump compression at 48h(P<0.05).LD group also experienced less dizziness,nausea and vomiting than the D group(P<0.05).Conclusion:Local infiltration analgesia combined with patient-controlled intravenous dezocine analgesia results in higher analgesia quality and less adverse reactions,which may be more favorable for use in unilateral total knee arthroplasty.
作者
朱鸣智
翟中云
Zhu Mingzhi;Zhai Zhongyun(Guangzhou Orthopedic Hospital,Guangzhou 510100,China)
出处
《广州医科大学学报》
2018年第6期86-88,共3页
Academic Journal of Guangzhou Medical University
关键词
地佐辛
罗哌卡因
术后镇痛
全膝置换
Dezocine
Ropivacaine
Postoperative analgesia
Total knee arthroplasty
