地塞米松复合罗哌卡因作用髂筋膜阻滞在老年髋关节置换术中的应用

Application of Dexamethasone Combined with Ropivacaine on Fascia Iliaca Block in Elderly Hip Arthroplasty

目的分析地塞米松复合罗哌卡因作用髂筋膜阻滞在老年髋关节中置换术中的应用。方法随机选取2021年3—12月期间该院收治的60例老年髋关节中置换术患者作为研究对象,将其随机分为两组,每组30例。两组皆进行气管插管全麻复合髂筋膜间隙阻滞,其中A组采用罗哌卡因麻醉;B组采用地塞米松复合罗哌卡因麻醉,比较两组患者的临床效果。结果两组患者注药后3、6、8、48 h视觉模拟评分比较,差异无统计学意义(P>0.05),B组注药后12、24、36 h的视觉模拟评分(1.34±0.32)分、(1.44±0.32)分、(1.95±0.67)分优于A组的(2.03±0.42)分、(2.58±0.57)分、(3.13±1.32)分,差异有统计学意义(t=7.158、9.552、4.366,P<0.05)。B组术后48 h内按压镇痛泵次数(3.21±1.24)次少于A组(6.21±2.45)次,差异有统计学意义(t=5.984,P<0.05)。B组不良反应共发生6例(20.00%),与A组5例(16.67%)比较,差异无统计学意义(χ^(2)=0.111,P>0.05)。结论地塞米松复合罗哌卡因作用髂筋膜阻滞在老年髋关节中置换术中的应用效果确切,可更好地缓解术中疼痛,延长围术期的镇痛时效,减少术后48 h内按压镇痛泵次数,安全性高,值得临床推广应用。

Objective To analyze the application of dexamethasone combined with ropivacaine on fascia iliaca block in elderly hip arthroplasty.Methods A total of 60 elderly patients with hip arthroplasty admitted to the hospital from March to December 2021 were randomly selected as the research subjects and randomly divided into two groups,30 cases in each group,both groups underwent tracheal intubation and general anesthesia combined with fascia iliaca space block.The patients in group A were anesthetized with ropivacaine;the patients in group B were treated with dexamethasone combined with ropivacaine anesthesia and the clinical effects of the two groups were compared.Re⁃sults There was no statistically significant difference in visual analog score in two groups at 3 h,6 h,8 h,and 48 h af⁃ter drug injection(P>0.05),the visual analog scores of group B at 12 h,24 h,and 36 h after injection was(1.34±0.32)points,(1.44±0.32)points,(1.95±0.67)points better than group A(2.03±0.42)points,(2.58±0.57)points and(3.13±1.32)points,the difference was statistically significant(t=7.158,9.552,4.366,P<0.05).The number of times of pressing the analgesic pump within 48 h after operation in group B(3.21±1.24)times was less than in group A(6.21±2.45)times,and the difference was statistically significant(t=5.984,P<0.05).A total of 6 cases(20.00%)of adverse reactions occurred in group B,compared with 5 cases(16.67%)in group A,the difference was not statistically signifi⁃cant(χ^(2)=0.111,P>0.05).Conclusion Dexamethasone combined with ropivacaine combined with fascia iliaca block is effective in elderly hip arthroplasty,which can better relieve intraoperative pain,prolong perioperative analgesia and reduce postoperative 48 hours.The number of internal pressure analgesia pumps has high safety and is worthy of clinical application.