摘要
目的:探讨桡骨远端骨折患者行臂丛神经阻滞时使用地塞米松联合罗哌卡因的镇痛效果及对炎症因子的影响。方法:选取110例桡骨远端骨折患者为研究对象,均行臂丛神经阻滞,按照使用麻醉药物不同分为对照组与观察组,每组各55例。对照组患者采用0.25%罗哌卡因;观察组患者采用10 mg地塞米松+0.25%罗哌卡因,药液量均为20 mL。比较两组患者感觉阻滞持续时间、术后疼痛情况(VAS评分)、术后补救镇痛率、血清白细胞介素6(IL-6)及肿瘤坏死因子α(TNF-α)水平、术后住院时间及不良反应发生情况。结果:观察组患者感觉阻滞持续时间长于对照组(P<0.05);术后2~48 h各时间点静息及活动时VAS评分及48 h补救镇痛率均低于对照组(P<0.05);术后24 h IL-6、TNF-α水平低于对照组(P<0.05)。观察组术后住院时间短于对照组(P<0.05);两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:地塞米松联合罗哌卡因行臂丛神经阻滞可提高桡骨远端骨折患者术后镇痛效果,减轻炎症应激,利于术后恢复。
Objective:To investigate the effect of dexamethasone combined with ropivacaine for brachial plexus block on analgesia in patients with distal radius fractures,and the effect on inflammatory factors.Methods:A total of 110 patients with distal radius fracture were divided into control group and observation group according to the different ways of intervention,each group was 55 cases.Both groups underwent brachial plexus block.The control group was 0.25%ropivacaine,and the observation group was dexamethasone 10 mg+0.25%ropivacaine.The liquid volume of the two groups was 20 mL.The duration of sensory block,postoperative pain score(VAS score),postoperative remedial analgesia rate,postoperative hospitalization time and adverse reactions were recorded in the two groups.The serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were detected.Results:Compared with the control group,the duration of sensory block in the observation group was longer(P<0.05).The pain scores of the observation group at rest and activity at each time point from 2 to 48 h after operation were decreased(P<0.05),and the remedial analgesia rate at 48 h after operation was lower(P<0.05).At 24 h after operation,the serum IL-6 and TNF-αlevels in the observation group was lower comparing with the control group(P<0.05).The postoperative hospital stay in the observation group was shorter comparing with the control group(P<0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups of patients(P>0.05).Conclusion:Dexamethasone combined with ropivacaine for brachial plexus block can improve the postoperative analgesic effect of patients with distal radius fractures,reduce inflammatory stress,and facilitate postoperative recovery.
作者
刘涛
刘昶
刘志军
LIU Tao;LIU Chang;LIU Zhi-jun(Department of Anesthesiology,Huangshi Love Health Hospital Affiliated of Hubei Polytechnic University,Huangshi 435000,Hubei,China)
出处
《川北医学院学报》
2025年第4期459-462,共4页
Journal of North Sichuan Medical College
基金
湖北省卫生健康委员会项目(WJ2019H469)。
关键词
桡骨远端骨折
臂丛神经阻滞
地塞米松
罗哌卡因
镇痛
炎症
Distal radius fracture
Brachial plexus block
Dexamethasone
Ropivacaine
Analgesia
Inflammation
