摘要
目的观察地塞米松复合罗哌卡因髂筋膜阻滞对全膝关节置换术(TKA)止血带反应的影响。方法纳入择期在全身麻醉下接受全膝关节置换术的患者60例,采用随机数字表法分为地塞米松组(30例,给予0.15 mg/kg地塞米松+0.3%罗哌卡因30 ml进行髂筋膜阻滞)、对照组(30例,给予0.3%罗哌卡因30 ml进行髂筋膜阻滞)。比较两组视觉模拟评分法(VAS)评分、静脉自控镇痛(PCA)追加次数、术后镇痛满意度及术后不良事件发生情况。结果术后12、48 h,地塞米松组静息状态、主动运动、被动运动的VAS评分分别为(1.68±0.54)、(2.03±0.34)、(2.33±0.45)分和(1.57±0.63)、(2.08±0.63)、(1.77±0.42)分,均低于对照组的(3.53±0.48)、(3.38±0.32)、(3.68±0.52)分和(3.18±0.54)、(3.17±0.66)、(3.12±0.33)分(P<0.05)。地塞米松组PCA追加次数为(1.23±0.43)次,对照组PCA追加次数为(1.52±0.52)次;地塞米松组PCA追加次数少于对照组(P<0.05)。地塞米松组术后镇痛满意度96.67%高于对照组的80.00%(P<0.05)。地塞米松组术后发热、恶心伴呕吐、寒战发生率分别为0、6.67%、3.33%,明显低于对照组的16.67%、26.67%、20.00%(P<0.05)。结论对全膝关节置换术患者应用地塞米松复合罗哌卡因髂筋膜阻滞,其镇痛效果好,PCA追加次数少,且安全性高,有推广应用价值。
Objective To observe the effect of dexamethasone combined with ropivacaine iliac fascia block on tourniquet response in total knee arthroplasty(TKA).Methods 60 patients scheduled to total knee arthroplasty under general anesthesia were divided into a dexamethasone group(30 cases,0.15 mg/kg dexamethasone+0.3%ropivacaine 30 ml for iliac fascia block)and a control group(30 cases,0.3%ropivacaine 30 ml for iliac fascia block)using a random number table method.Both groups were compared in terms of Visual Analogue Scale(VAS)scores,the number of patient-controlled analgesia(PCA)attempts,postoperative analgesia satisfaction,and the occurrence of postoperative adverse events.Results At 12 and 48 h after surgery,the VAS scores of resting state,active exercise,and passive exercise in the dexamethasone group were(1.68±0.54),(2.03±0.34),(2.33±0.45)points,and(1.57±0.63),(2.08±0.63),(1.77±0.42)points,which were lower than those of the control group[(3.53±0.48),(3.38±0.32),(3.68±0.52)points,and(3.18±0.54),(3.17±0.66),(3.12±0.33)points](P<0.05).The number of PCA attempts in the dexamethasone group was(1.23±0.43)times,while the number of PCA attempts in the control group was(1.52±0.52)times;the number of PCA attempts in the dexamethasone group was less than that in the control group(P<0.05).The satisfaction rate of postoperative analgesia in the dexamethasone group was 96.67%,which was higher than 80.00%in the control group(P<0.05).The incidences of postoperative fever,nausea with vomiting and chills in the dexamethasone group were 0,6.67%and 3.33%,which were significantly lower than those in the control group(16.67%,26.67%and 20.00%)(P<0.05).Conclusion Dexamethasone combined with ropivacaine Iliac fascia block for patients with total knee arthroplasty shows good analgesic effect,fewer PCA attempts.It is safe,and has value for promotion and application.
作者
叶月宏
柳垂亮
何妹仪
贾振华
陈双云
YE Yue-hong;LIU Chui-liang;HE Mei-yi(Department of Anesthesiology,Fosun Chancheng Hospital,Foshan 528000,China)
出处
《中国实用医药》
2025年第21期92-95,共4页
China Practical Medicine
基金
佛山市医学科研基金项目(项目编号:20220266)。
关键词
地塞米松
罗哌卡因
髂筋膜阻滞
止血带反应
Dexamethasone
Ropivacaine
Iliac fascia block
Tourniquet response
