罗哌卡因持续局部浸润用于膝关节置换术后镇痛的研究

Continuous intraarticular infusion of ropivacaine for postoperative pain following total knee arthroplasty

目的:观察膝关节置换术后关节腔内置管使用罗哌卡因持续局部浸润镇痛的效果。方法 ASA分级I^II级,择期行全膝关节置换术的患者30例,随机分为两组:A组(n=15)为罗哌卡因组,关节内持续输注0.2%罗哌卡因,速度5ml/h,总量300ml;B(n=15)组为对照组,关节内持续输注生理盐水,速度及总量同A组。观察并比较术后第1、2、3d及出院时的VAS评分,术后吗啡用量,不良反应发生率及住院时间。结果 A组术后第1、2、3d的VAS评分低于B组,术后吗啡用量少于B组,不良反应发生率小于B组,平均住院时间较B组缩短。结论膝关节内置管使用罗哌卡因持续局部浸润镇痛可减轻全膝关节置换术后疼痛,减少吗啡用量,缩短患者住院时间。

Objective To observe the ef ects of continuous intraarticular infusion of ropivacaine for postoperative pain fol owing total knee arthroplasty(TKA).Methods 30 patients,ASA I^II,undergoing selective TKA were randomly divided into two group with 15 cases each:the ropivacaine group(group A)and the control group(group B).Group A underwent continuous intraarticular infusion with 300 ml ropivacaine 0.2%at a speed of 5ml/h through an electronic infusion pump and group B had an infusion with 300ml saline at the same speed.Parameters analyzed over the first three days and at discharge included VAS scale,opioid use,incidence of side ef ects and length of hospital stay.Results Patients in group A showed a decrease in VAS and opioid use in the first three days.The incidence of postoperative side ef ect decreased in group A and length of hospital stay also reduced in group A compared to groupB.Conclusion Continuous intraartcular infusion of ropivacaine through an electronic pump is ef ective in relieving pain and reducing postoperative opioid use and length of hospital stay after TKA.