摘要
目的 观察硫酸镁对罗哌卡因股神经阻滞镇痛的影响.方法 选择行全身麻醉下单侧人工全膝关节置换术后采用股神经阻滞镇痛的患者60例,采用随机数字表法分为硫酸镁复合罗哌卡因组（M组）和单纯罗哌卡因组（C组）,每组30例.M组阻滞药物配方为0.2%罗哌卡因复合0.15%硫酸镁的混合液20 mL;C组阻滞药物配方为0.2%罗哌卡因20 mL.术后采用视觉模拟评分法（VAS评分）观察患者的疼痛评分,记录补充镇痛的吗啡使用率和吗啡的累计用量,观察镇痛的相关并发症.结果 两组术后4h、8h、12 h、24 h静息状态下VAS评分差异均无统计学意义（均P〉0.05）;与C组比较,M组在12 h进行膝关节持续被动活动（CPM）时VAS评分下降,差异有统计学意义（t=2.800,P=0.009）,24 h进行膝关节CPM时VAS评分也降低,差异有统计学意义（t=2.934,P=0.012）;M组术后12 h、24h进行膝关节CPM时累计吗啡用量分别为（2.78±0.32）mg、（2.05±0.16）mg,均低于C组的（4.10±0.85）mg、（2.44±0.25）mg,差异均有统计学意义（t=7.960、2.632,均P〈0.05）.两组均未出现明显的镇痛相关并发症.结论 硫酸镁能增强罗哌卡因股神经阻滞镇痛的效果,减少患者术后吗啡的用量,且安全性好,可在临床推广应用.
Objective To evaluate the effects of magnesium sulphate on the analgestic efficacy of nerve block analgesia with ropivacaine. Methods Sixty cases who used femoral nerve block analgesia after unilateral total knee arthroplasty under the general anesthesia were selected,and according to digital table they were randomly divided into two groups（ n=30 each）：magnesium sulfate plus ropivacaine（ group M） and ropivacaine（ group C） . The solution （20mL） of 0. 2% ropivacaine and 0. 15% magnesium sulphate were administered to group M,and 20mL solution of 0.2% ropivacaine was given to the group C. The pain score was measured by visual analogue scale（VAS）. The supplementary usage and cumulative dosage of morphine were recorded and the analgesia relevant complications were observed. Results The results of this study indicated that 4h,8h,12h and 24h after the operation,the VAS scores had no statistically significant difference （ all P〉0. 05 ） at rest, which in group M was significantly decreased compared with group C at 12h（t=2. 800,P=0. 009） and 24h（t=2. 934,P=0. 012） after treated with continuous passive motion （ CPM） postoperatively. The cumulative dosages of morphine when patients undergo CPM of knee joint in group M were （2.78 ±0.32）mg,（2.05 ±0.16）mg,respectively,which were significantly lower than those in the groupC[（4.10±0.85）mg,（2.44±0.25）mg]（t=7.960,2.632,all P〈0.05）.No obvious analgesia relevant complications occurred in both two groups. Conclusion Magnesium sulphate can enhance the efficacy of postopera-tive femoral nerve block analgesia with ropivacaine, reduce the usage of morphine without increasing the analgesia relevant complications.
出处
《中国基层医药》
CAS
2017年第22期3373-3376,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
硫酸镁
罗哌卡因
自主神经传导阻滞
麻醉和镇痛
Magnesium sulfate
Ropivacaine
Autonomic nerve block
Anesthesia and analgesia
