| 何桥,张小舟,游洪波,等.硫酸镁联合罗哌卡因鸡尾酒应用于全髋关节置换术后早期镇痛.骨科,2022,13(1): 47-51. |
| 硫酸镁联合罗哌卡因鸡尾酒应用于全髋关节置换术后早期镇痛 |
| Postoperative Early Analgesia by Magnesium Sulfate Combined with Ropivacaine Cocktail in Total Hip Arthroplasty |
| 投稿时间：2021-05-25 |
| DOI：10.3969/j.issn.1674-8573.2022.01.011 |
| 中文关键词: 全髋关节置换术 硫酸镁 罗哌卡因 镇痛 |
| 英文关键词: Total hip arthroplasty Magnesium sulfate Ropivacaine Analgesia |
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| 中文摘要: |
| 目的 评价加入硫酸镁的鸡尾酒麻醉混合剂在全髋关节置换术（total hip arthroplasty，THA）后早期的镇痛效果。方法 选择2019年9月至2020年11月在武汉科技大学附属孝感医院骨科行初次单侧THA病人共60例，随机分为观察组（硫酸镁250 mg+罗哌卡因50 mg+曲安奈德25 mg+0.9%生理盐水至40 mL）和对照组（罗哌卡因50 mg+曲安奈德25 mg+0.9%生理盐水至40 mL），每组30例。观察组男13例，女17例，年龄为（68.27±4.73）岁；对照组男16例，女14例，年龄为（67.90±4.55）岁。记录并比较两组病人术后6、12、24、48、72 h静息及12、24、48、72 h活动时疼痛视觉模拟量表（visual analogue scale，VAS）评分、术后补救镇痛率、术后髋关节活动度、镇痛泵在术后各时间点的用量，以及术后相关并发症发生情况。结果 观察组病人术后6、12、24、48 h静息及12、24、48 h活动时VAS评分均小于对照组，差异均有统计学意义（P＜0.05），但两组术后72 h静息和活动时VAS评分的差异无统计学意义（P＞0.05）。观察组术后0~11 h、12~23 h补救镇痛率低于对照组，差异有统计学意义（P＜0.05）。观察组术后1、2 d髋关节屈髋活动度大于对照组，差异有统计学意义（P＜0.05）。观察组术后6、12、24、36 h的镇痛泵用量小于对照组，差异有统计学意义（P＜0.05）。两组手术相关并发症的差异无统计学意义（P＞0.05）。结论 THA中使用加入硫酸镁的鸡尾酒麻醉混合剂，能有效减轻病人术后早期疼痛，减少术后镇痛药的使用量，有助于病人早期康复，且安全有效。 |
| 英文摘要: |
| Objective To evaluate the early analgesic efficacy of a cocktail anesthetic mixture of magnesium sulfate combined with ropivacaine after total hip arthroplasty (THA). Methods A total of 60 patients treated with first unilateral THA in the Orthopedics of Xiaogan Hospital from September 2019 to November 2020 were randomly assigned into the observation group (30 patients with 40 mL of magnesium sulfate 250 mg+ropivacaine 50 mg+triamcinolone 25 mg+0.9% normal saline) and the control group (30 patients with 40 mL of ropivacaine 50 mg+triamcinolone 25 mg+0.9% normal saline). The observation group included 13 men and 17 women, aged (68.27±4.73) years old. The control group included 16 men and 14 women, aged (67.90±4.55) years old. Visual analogue scale (VAS) scores of patients at 6, 12, 24, 48 and 72 h of rest and 12, 24, 48 and 72 h of activity after operation, postoperative relief analgesia rate, postoperative hip activity, dosage of analgesic pump at various postoperative time points, and the occurrence of postoperative complications were recorded and compared between the two groups. Results The VAS scores in the observation group at 6, 12, 24 and 48 h of rest and 12, 24 and 48 h of activity were significantly lower than those in the control group (P＜0.05), but there was no significant difference between the two groups at 72 h of rest and activity (P＞0.05). The remedial analgesia rate in the observation group at 0-11 h and 12 h-23 h after operation was significantly lower than that in the control group (P＜0.05). The hip flexion activity in the observation group at 1st and 2nd d after operation was significantly greater than that in the control group (P＜0.05). The dosage of analgesic pump at 6, 12, 24 and 36 h after operation in the observation group was significantly less than that in the control group (P＜0.05). There was no significant difference in surgery-related complications between the two groups (P＞0.05). Conclusion Anesthesia periarticular cocktail combined with magnesium sulfate can effectively alleviate early postoperative pain, significantly reduce the usage of postoperative analgesics, safely and effectively rehabilitate patients in the early postoperative period after THA. |
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