肩袖修复手术时不同浓度罗哌卡因连续肌间沟镇痛对术后镇痛及运动功能影响的比较

Continuous interscalene analgesia with two different concentrations of Ropivacaine after open rotator cuf repair: effects on postoperative analgesia and motor function

目的比较术后48 h肌间沟导管连续输注0.3%和0.2%浓度罗哌卡因的镇痛效果。方法将80例择期行肩袖修复术患者随机分为两组,通过肌间沟导管等速分别给予0.3%和0.2%浓度罗哌卡因,观察两组患者术后疼痛评分、运动阻滞强度、术后首夜睡眠质量、吗啡用量。结果 0.3%罗哌卡因组吗啡用量明显减少,睡眠质量更佳,术侧手部握力、视觉模拟评分两组间差异无统计学意义。结论肩袖修复术后48 h,通过肌间沟导管输入0.3%罗哌卡因并不增加运动阻滞强度,且吗啡用量明显减少,术后首夜睡眠质量更佳。

Objective To compare the analgesia of continuous infusion with Ropivacaine at 0. 2% and 0.3% administered through an interscalene catheter for the first 48 hours after surgical operation and their side effects. Methods Eighty consecutive patients scheduled for elective open rotator cur repair were randomized into two groups to receive continuous infusion of Ropivacaine either at 0.2% or at 0.3% for 48 hours through an iuterscalene catheter. Pain score, intensity of motor block, quality of sleep during the first postoperative night and morphine consumption were recorded down. Results Total morphine consumption was significantly re- duced and quality of sleep was significantly better in the group with 0.3% of Ropivacaine. Handgrip, visual analog scale score and side effects were similar in both the two groups. Conclusion The use of Ropivacaine at 0.3% through an interscalene catheter for the first 48 hours after open rotator cur repair provides a significant reduction of morphine consumption and a better sleep quality for the first postoperative night without an increase in intensity of motor block or side effects.