不同浓度罗哌卡因复合地佐辛膝关节腔内注射在膝关节镜术后镇痛中的效果

Effects of intraarticular injection using different concentrations of ropivacaine combined with dezocine on postoperative pain after arthroscopic knee surgery

目的探讨不同浓度罗哌卡因复合地佐辛膝关节腔内注射在膝关节镜术后镇痛中的效果。方法将96例因膝关节骨关节炎行膝关节镜手术患者随机分为A、B、C 3组,每组32例。A、B、C 3组患者分别给予0.25%罗哌卡因、0.2%罗哌卡因、0.15%罗哌卡因联合地佐辛膝关节腔内注射进行术后镇痛。比较3组患者术后应激反应、疼痛视觉模拟量表(VAS)评分及不良反应发生情况。结果 A组术后4 h、24 h的血清超氧化物歧化酶水平均高于B组与C组,而血清丙二醛水平及VAS评分均低于B组与C组(均P<0.05)。3组患者术后24 h内恶心呕吐、皮肤瘙痒、嗜睡及低血压发生率比较,差异均无统计学意义(P>0.05)。结论 0.25%罗哌卡因复合地佐辛膝关节腔内注射应用于膝关节镜术后的镇痛效果显著,有效减轻氧化应激反应,安全性好。

Objective To investigate the effects of intraarticular injection using different concentrations of ropivacaine combined with dezocine in postoperative analgesia after arthroscopic knee surgery. Methods Ninety-six patients undergoing arthroscopic knee surgery for knee osteoarthritis were randomly divided into three groups,group A,group B and group C,with 32 cases in each group.The patients in group A,group B and group C were given 0.25% ropivacaine,0.2% ropivacaine,and 0.15% ropivacaine,respectively,combined with dezocine for intraarticular injection in postoperative analgesia.Postoperative stress response,Visual Analogue Scale（VAS） score,and incidence of adverse reactions were compared among the three groups. Results The levels of serum superoxide dismutase at postoperative 4 h and 24 h in group A were higher than those in group B and group C,while the serum malondialdehyde level and VAS score in group A were lower than those in group B and group C（all P 〈0.05）.There was no significant difference in the incidence rate of nausea and vomiting, skin pruritus,drowsiness,or hypotension among the three groups within 24 hours after operation（ P 〉0.05）. Conclusion Intraarticular injection with 0.25% ropivacaine combined with dezocine has a significant analgesic effect after arthroscopic knee surgery,effectively alleviating oxidative stress and achieving good safety.