罗哌卡因复合液持续浸润镇痛在腰椎内固定术后的应用效果观察

Application efficacy of continuous infiltration analgesia with ropivacaine compound solution following lumbar internal fixation

目的观察罗哌卡因复合液持续浸润镇痛在腰椎内固定术后的应用效果。方法将80例行后路腰椎内固定术的患者随机分为观察组与对照组,每组40例。观察组术后采用罗哌卡因复合液持续浸润镇痛,对照组采用静脉镇痛泵镇痛。比较两组患者术前、术后清醒即刻、术后3 h、术后6 h、术后12 h、术后24 h、术后48 h及首次下地行康复锻炼后6 h的疼痛视觉模拟量表(VAS)评分。比较术后48 h内两组患者阿片类及非甾体类药物用量,观察两组患者术后不良反应发生情况。结果观察组术后各时间点的VAS评分均低于对照组(均P <0. 05)。观察组术后48 h内曲马多注射液及特耐用量均低于对照组,术后不良反应发生率低于对照组(均P <0. 05)。结论腰椎后路内固定术后采用罗哌卡因复合液伤口持续浸润镇痛效果确切,可降低患者术后疼痛及不良反应发生率,并能减少术后止痛药物用量。

Objective To observe the application efficacy of continuous infiltration analgesia with ropivacaine compound solution following lumbar internal fixation. Methods Eighty patients undergoing posterior lumbar internal fixation were randomly divided into observation group and control group,with 40 cases in each group.The observation group was given ropivacaine compound solution for continuous infiltration analgesia after operation,while the control group was given intravenous analgesia pump for analgesia.Pain Visual Analogue Scale(VAS) scores were compared between the two groups before operation,immediately after postoperative recovery from anesthesia,3,6,12,24 and 48 hours after operation,as well as 6 hours after rehabilitation exercise following the first ambulation.The consumption of opioids and non-steroidal drugs was compared between the two groups within 48 hours after operation,and the incidence of postoperative adverse reactions was observed in the two groups. Results The VAS scores in the observation group at each time point after operation were lower than those in the control group(all P <0.05).The observation group had lower consumption of Tramadol Injection and parecoxib within 48 hours after operation,as well as lower incidence rate of postoperative adverse reactions than the control group(all P <0.05). Conclusion After lumbar posterior internal fixation,applying continuous infiltration of ropivacaine compound solution to wound analgesia has definite efficacy,which can reduce the incidence rates of postoperative pain and adverse reactions as well as decrease the consumption of postoperative analgesics.