不同浓度右美托咪定在全膝关节置换术连续收肌管阻滞中的应用效果比较

Comparison of Different Concentrations of Dexmedetomidine in Continuous Adductor Block in Total Knee Arthroplasty Surgery

目的:比较不同浓度右美托咪定在全膝关节置换术(TKA)连续收肌管阻滞中的应用效果。方法:将2020年8月-2021年8月厦门大学附属福州第二医院收治的160例TKA患者随机分成对照组(n=80)和研究组(n=80),对照组应用0.5μg/mL右美托咪定,研究组应用1.0μg/mL右美托咪定,两组均联合罗哌卡因进行连续收肌管阻滞麻醉。分析比较两组的术后疼痛、镇痛情况、股四头肌分级、不良反应发生情况。结果:研究组术后6、12、24、48 h VAS评分均低于对照组(P<0.05);镇痛泵按压、补救镇痛次数少于对照组(P<0.05);两组术后48 h的股四头肌分级比较,差异无统计学意义(P>0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:1.0μg/mL右美托咪定在TKA连续收肌管阻滞中的应用效果较好,可减轻患者术后疼痛,提高镇痛效果,值得推广。

Objective:To compare the effects of different concentrations of Dexmedetomidine in continuous adductor block in total knee arthroplasty(TKA).Method:A total of 160 patients with TKA treated in Fuzhou Second Hospital Affiliated to Xiamen University from August 2020 to August 2021 were randomly divided into control group(n=80)and study group(n=80).The control group was treated with 0.5μg/mL Dexmedetomidine,the study group was treated with 1.0μg/mL Dexmedetomidine,both groups were combined with Ropivacaine for continuous adductor block anesthesia.The postoperative pain,analgesia,quadriceps femoris grading and adverse reactions were analyzed and compared.Result:The VAS scores at 6,12,24 and 48 h after operation in the study group were lower than those of the control group(P<0.05);the times of analgesic pump pressing and remedial analgesia were lower than those of the control group(P<0.05);there was no significant difference in quadriceps femoris grading between the two groups at 48 h after operation(P>0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:1.0μg/mL Dexmedetomidine has a good effect in continuous adductor tube block in TKA operation.It can reduce postoperative pain and improve analgesic effect,it is worth popularizing.