摘要
目的：观察罗哌卡因或利多卡因持续股神经阻滞用于全膝关节置换术（total knee arthroplasty，TKA）后患者康复镇痛的效果。方法：选择ASAⅠ～Ⅱ级行单侧TKA患者60例，术后镇痛方法采用持续静脉和连续股神经阻滞。随机均分为三组：静脉组（A组）、利多卡因组（B组）和罗哌卡因组（C组）。所有患者均实施气管插管全身麻醉。A组患者术后静脉给予持续输注曲马多镇痛，B和C组分别通过股神经阻滞导管间断注射0．5％盐酸利多卡因镇痛或0．2％罗哌卡因，三组患者镇痛持续3天。记录VAS疼痛评分，开始下床活动情况和不良反应发生状况。结果：B、C组患者在术后6h、24h、32h、48h、56h及72h的VAS评分明显低于A组，P〈0．05或P〈0．01；术后C组患者VAS评分小于B组，但无统计学差异。B、C组患者术后的下地次数和行走距离均大于A组。B、C组不良反应发生例数明显少于A组，使用止痛药例数C组明显少于B组。结论：罗哌卡因用于连续股神经阻滞术后镇痛，效果良好，安全性能好，不良反应发生率低，是TKA术后理想的镇痛方法。
Objective ： To observe the effect of continuous femoral nerve block with ropivacaine on postoperative pain and rehabilitation after total knee arthroplasty （TKA）. Methods： Sixty ASA Ⅰ - Ⅱ patients undergoing unilateral TKA under general anesthesia were selected . They were randomly divided into three groups according to the postoperative analgesia regimens. The patients in group A were given continuous intravenous tramadol, the patients in group B and C received intermitted injection of 0.5% lidocaine or 0.2% ropivacaine through nerve block catheter. Postoperative analgesia therapy lasted for 3 days. Visual analogue score （VAS） pain scores, mobilization and complications were recorded. Results： The VAS pain scores at postoperative 6, 24, 32, 48,56 and 72h in group B and C were significantly lower than those in group A. Frequency and duration of walking were higher and longer in group B and C than those in group A. Compared with group A, a significantly lower incidence of side effects was noted in group B and C. Conclusion： The continuous femoral nerve block with ropivacaine provides better pain relief with greater safety and fewer side effects. So it is considered to be an ideal analgesia method for TKA surgery.
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2008年第4期214-217,共4页
Chinese Journal of Pain Medicine
关键词
罗哌卡因
神经阻滞
股神经
全膝关节置换
镇痛
Ropivacaine
Nerve block
Femoral nerve
Total knee arthroplasty
Analgesia
