医学信息2024，Vol.37Issue(9)：112-117,6.DOI:10.3969/j.issn.1006-1959.2024.09.021
右美托咪定复合低浓度罗哌卡因单次股神经阻滞对老年患者膝关节置换术的影响
Effect of Single Femoral Nerve Block with Dexmedetomidine Combined with Low Concentration Ropivacaine on Knee Arthroplasty in Elderly Patients
摘要
Abstract
Objective To investigate the effect of single femoral nerve block with dexmedetomidine combined with low concentration ropivacaine on postoperative analgesia and postoperative muscle strength recovery in elderly patients after knee arthroplasty.Methods A total of 60 patients undergoing total knee arthroplasty(TKA)under general anesthesia with laryngeal mask intubation from March 2020 to September 2021 in Shenzhen Longgang Orthopaedics Hospital were selected and randomly divided into experimental group(DR group)and control group(R group),with 30 patients in each group.DR group and R group were treated with 0.15％ropivacaine+1 μg/kg dexmedetomidine and 0.15％ropivacaine for ultrasound-guided femoral nerve block,respectively.Postoperative patient-controlled intravenous analgesia(PCIA)was performed in both groups.The pain degree(VAS)and quadriceps muscle strength at different time points(4,8,12,18,24,48 h)after operation were compared between the two groups.The first pressing time of PCIA after operation,the times of PCA pressing at each time interval within 48 h after operation,related complications and adverse reactions were recorded in the two groups.Results The VAS score of resting state and motion state at 8,12 and 24 h after operation in DR group was lower than that in R group(P＜0.05).The first PCA pressing time of DR group was(5.64±1.73)h,which was longer than(3.15±1.52)h of R group,and the difference was statistically significant(P＜0.05).The times of PCA pressing at 4-8 h,8-12 h and 12-24 h after operation in DR group were less than those in R group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Compared with ropivacaine alone,dexmedetomidine combined with low concentration ropivacaine can enhance the block effect,prolong the postoperative analgesia time,have less effect on the recovery of postoperative muscle strength,and will not increase the adverse reactions,which can provide better analgesic effect for TKA patients.关键词
右美托咪啶/股神经阻滞/全膝关节置换/术后镇痛Key words
Dexmedetomidine/Femoral nerve block/Total knee arthroplasty/Postoperative analgesia分类
临床医学引用本文复制引用
李严棠,覃军,李捷,傅翔,李波..右美托咪定复合低浓度罗哌卡因单次股神经阻滞对老年患者膝关节置换术的影响[J].医学信息,2024,37(9):112-117,6.基金项目
1.深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(编号:LGWJ2022105) （编号:LGWJ2022105）
2.龙岗区医学重点学科建设经费资助项目(编号:深龙卫健通[2024]1号) （编号:深龙卫健通[2024]1号）
