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罗哌卡因联合阿芬太尼对膝关节镜手术术后镇痛的有效性和安全性
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| 篇名： | 罗哌卡因联合阿芬太尼对膝关节镜手术术后镇痛的有效性和安全性 |
| TITLE： | Efficacy and safety of ropivacaine combined with alfentanil for analgesia after knee arthroscopic surgery |
| 摘要： | 目的 探讨膝关节腔内注射罗哌卡因联合阿芬太尼对膝关节镜手术患者术后镇痛的有效性和安全性。方法选取2022年3－9月于恩施土家族苗族自治州中心医院接受膝关节镜手术的患者60例，采用随机数字表法将其分为试验组和对照组，每组30例。膝关节镜手术结束后，对照组患者于膝关节腔内注射0.25%罗哌卡因50mg，试验组患者于膝关节腔内注射0.25%罗哌卡因50mg+阿芬太尼0.15μg/kg。比较两组患者术后首次补救镇痛时间，术后补救镇痛药物总量，术后不同监测时间点的静息时疼痛数字评分量表（NRS-R）评分、运动时疼痛数字评分量表（NRS-M）评分、心率、平均动脉血压、脉搏氧饱和度，以及术后低血压、呼吸抑制、恶心、呕吐等不良反应发生率。结果与对照组相比，试验组患者的术后首次补救镇痛时间显著延长，术后补救镇痛药物总量显著减少（P＜0.001）；试验组患者在各个监测时间点的NRS-R、NRS-M评分都更低，差异均有统计学意义（P组间＜0.001），且时间与分组之间存在交互效应（P组间×时间＜0.001）；试验组患者的心率、平均动脉血压、脉搏氧饱和度变化相对较小，差异均无统计学意义（P组间＞0.05），且时间与分组之间无交互效应（P组间×时间＞0.05）。两组患者术后低血压、呼吸抑制、恶心、呕吐等不良反应发生率比较，差异均无统计学意义（P＞0.05）。结论膝关节镜手术术后注射罗哌卡因联合阿芬太尼，镇痛的有效性和安全性均较高，可明显延长镇痛时效。 |
| ABSTRACT： | OBJECTIVE To explore the efficacy and safety of intra-articular injection of ropivacaine combined with alfentanil for postoperative analgesia in patients who underwent knee arthroscopic surgery. METHODS A total of 60 patients who underwent knee arthroscopic surgery were collected from the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from March to September in 2022， and then divided into trial group and control group with random number table method， with 30 cases in each group. The control group received intra-articular injection of 0.25% ropivacaine 50 mg， and the trial group received intra-articular injection of 0.25% ropivacaine 50 mg+alfentanil 0.15 μg/kg.The first postoperative remedial analgesia time， the total amount of postoperative remedial drugs， numerical rating scale at rest （NRS-R） scores， numerical rating scale at movement （NRS-M） scores， heart rate， mean arterial blood pressure， and pulse oxygen saturation during exercise at different monitoring time points after surgery， the incidence of adverse drug reactions such as hypotension， respiratory depression， nausea， and vomiting after surgery were compared between 2 groups. RESULTS Compared with the control group， the first postoperative remedial analgesia time was significantly longer in the trial group， and the total amount of postoperative remedial drugs was significantly reduced （P＜0.001）. The trial group had lower NRS-R and NRS-M scores at each monitoring time point， with statistically significant differences （P＜0.001）， and there was an interactive effect between time and groups （P＜0.001）. The changes in heart rate， mean arterial blood pressure， and pulse oxygen saturation of patients in the trial group were relatively small， with no statistically significant differences （P＞0.05）， and there was no interactive effect between time and groups （P＞0.05）. There was no statistical significance in the incidence of adverse drug reactions between 2 groups， such as postoperative hypotension， respiratory depression， nausea， vomiting （P＞0.05）. CONCLUSIONS The intra- articular injection of ropivacaine combined with alfentanil shows good efficacy and safety for post-knee arthroscopic analgesia， and significantly prolongs the analgesic duration of ropivacaine. |
| 期刊： | 2023年第34卷第08期 |
| 作者： | 何亚鹏；叶宗；李磊；覃辉；吴昊；陈佳；朱贤林 |
| AUTHORS： | HE Yapeng，YE Zong，LI Lei，QIN Hui，WU Hao，CHEN Jia，ZHU Xianlin |
| 关键字： | 膝关节镜手术；阿芬太尼；罗哌卡因；镇痛效果；安全性 |
| KEYWORDS： | knee arthroscopic surgery； alfentanil； ropivacaine； analgesic effect； safety |
| 阅读数： | 753 次 |
| 本月下载数： | 7 次 |
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