| 地塞米松联合右美托咪定对罗哌卡因股神经阻滞用于老年患者全膝关节置换术后镇痛效果的评价 |
| 投稿时间：2021-09-03 修订日期：2022-01-24 点此下载全文 |
| 引用本文：董发慧,韩金刚.地塞米松联合右美托咪定对罗哌卡因股神经阻滞用于老年患者全膝关节置换术后镇痛效果的评价[J].药学实践杂志,2023,41(2):125~129 |
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| 中文摘要:目的 观察地塞米松联合右美托咪定对罗哌卡因股神经阻滞用于老年患者全膝关节置换术后镇痛效果的影响。方法 选取医院2019年1月至2020年12月关节外科收治的行全膝关节置换术的老年患者96例，术后均采用超声引导下股神经阻滞，按照神经阻滞药物配方分为对照组（C）、地塞米松组（E1）、右美托咪定组（E2）、地塞米松联合右美托咪定组（E3），收集患者的一般情况和手术情况，比较4组患者术后6、12、24、48 h的VAS评分和术后6 h的Ramsay镇静评分，分析各组患者术后吗啡消耗量及镇痛持续时间，观察术后6 h的不良反应发生率。结果 4组患者的一般情况和手术情况均无统计学差异；E2、E3组的术后6 h的VAS评分、Ramsay 评分显著低于C组，E3组的术后12 h的VAS评分显著低于C组，而4组术后24、48 h的VAS评分无统计学差异；E2、E3组的术后吗啡消耗量显著少于C组，且E1、E2、E3组的镇痛持续时间显著长于C组；4组患者术后呼吸抑制、恶心、呕吐、头晕等不良反应的发生率不具有统计学差异。结论 地塞米松联合右美托咪定能够增强老年患者全膝关节置换术后罗哌卡因股神经阻滞的镇痛效果，且不增加不良反应，更加安全有效。 |
| 中文关键词:地塞米松 右美托咪定 全膝关节置换 股神经阻滞 镇痛 |
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| Analgesia effect of dexamethasone combined with dexmedetomidine on femoral nerve block with ropivacaine after total knee replacement in elderly patients |
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| Abstract:Objective To observe the analgesia effect of dexamethasone combined with dexmedetomidine on femoral nerve block with ropivacaine after total knee replacement in elderly patients. Methods 96 elderly patients undergoing total knee replacement with femoral nerve block analgesia from January 2019 to December 2020 in the hospital were enrolled in the study. Patients were divided into control group (C), dexamethasone group (E1), dexmedetomidine group (E2) and dexamethasone combined with dexmedetomidine group (E3) according to nerve block drug formulation. The general data and operation condition were collected, the VAS score at 6 h, 12 h, 24 h, 48 h and the Ramsay sedation score at 6 h after surgery were compared, the postoperative morphine consumption and duration of analgesia were analyzed, and the incidence of adverse reactions after operation was observed. Results Patients in four groups showed no significant differences in general data and operation time. The VAS score and Ramsay score at 6 h postoperatively in E2 and E3 were significantly lower than that in C, while there were no significant differences in VAS score at 24 h and 48 h postoperatively among four groups. Postoperative morphine consumption in E2 and E3 was significantly lower, and the duration of analgesia in E1, E2 and E3 was significantly longer than that in C. There was no statistical difference in the incidence of respiratory depression, nausea, vomiting, dizziness and other adverse reactions after operation among four groups. Conclusion Dexamethasone combined with dexmedetomidine could enhance the analgesic effect of femoral nerve block with ropivacaine in elderly patients after total knee replacement without increasing the adverse reactions, which would be both safe and effective. |
| keywords:dexamethasone dexmedetomidine total knee replacement femoral nerve block analgesia |
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