摘要
[目的]比较超声引导下布比卡因脂质体(liposomal bupivacaine,LB)与罗哌卡因(ropivacaine,ROP)收肌管阻滞在全膝关节置换术(total knee arthroplasty,TKA)的镇痛效果。[方法]选择2024年2月—2024年11月98例老年TKA患者,以随机数字表法分为两组。应用超声引导下收肌管阻滞,给予LB 49例,ROP 49例,比较两组临床和镇痛资料。[结果]两组患者均顺利完成手术,术中无严重并发症。两组围手术期不良反应发生率的差异无统计学意义(P>0.05)。LB组术后48 h的30 s椅子站立测试(30-second chair-stand test,30 s-CST)显著优于ROP组[(3.5±0.7)次vs(3.0±0.4)次,P<0.001];但是,两组间计时起立测试(timed up and go,TUG)的差异无统计学意义(P>0.05)。镇痛方面,术后12、24、48、72 h LB组在静息和活动状态下VAS评分均显著优ROP组(P<0.05)。此外,LB组的术后首次按压镇痛泵时间[(20.8±2.4)h vs(10.1±1.3)h,P<0.001]和术后24 h补救镇痛率(6.1%vs 28.6%,P=0.003)均显著优于ROP组。[结论]老年TKA超声引导收肌管阻滞,LB在改善其术后早期膝关节功能,减轻早期疼痛程度方面,均优于ROP。
[Objective]To compare the analgesic effects of ultrasound-guided adductor block with liposomal bupivacaine(LB)versus ropivacaine(ROP)in total knee arthroplasty(TKA).[Methods]A total of 98 elderly patients who were undergoing TKA from February 2024to November 2024 were included in this study and divided into two groups by random number table method.Before operation,the ultrasound-guided adductor block was conducted with corresponding drugs.The clinical and analgesic data of the 49 patients with LB and the 49patients with ROP were compared.[Results]TKA was successfully completed in both groups without serious complications.There was no significant difference in the incidence of perioperative adverse reactions between the two groups(P>0.05).The LB group proved significantly superior to the ROP group in term of 30-second chair-stand test(30s-CST)48h after surgery[(3.5±0.7)times vs(3.0±0.4)times,P<0.001],despite of the fact there was no significant difference in TUG between the two groups(P>0.05).Regarding to analgesia,the LB group was significantly better than the ROP group in VAS scores at resting and active conditions 12 hours,24 hours,48 hours and 72 hours postoperatively(P<0.05).In addition,the LB was also proved significantly superior to the ROP group in terms of time to press the analgesic pump firstly[(20.8±2.4)hours vs(10.1±1.3)hours,P<0.001]and salvage analgesic use rate 24 hours after surgery(6.1%vs 28.6%,P=0.003).[Conclusion]The LB used in ultrasound-guided adductor block is superior to ROP in terms of improving early knee function and reducing early pain in total knee arthroplasty in the elderly.
作者
王梅玲
陈娟
唐伟
吴刚
WANG Mei-ling;CHEN Juan;TANG Wei;WU Gang(Department of Anesthesiology,Tai'an Maternal and Child Health Hospital,Tai'an 271000,Shandong,China;Department of Anesthesiology,Taian 88 Hospital,Taian 271000,Shandong,China;Department of Anesthe-siology,The 960 th Hospital,PLA Joint Logistic Support Force,Jinan 250031,Shandong,China)
出处
《中国矫形外科杂志》
北大核心
2025年第8期736-739,743,共5页
Orthopedic Journal of China
作者简介
王梅玲,副主任医师,研究方向:临床麻醉,电子信箱:wangmeiling123199@163.com;通信作者:唐伟,电子信箱:182848861@qq.com;通信作者:吴刚,电子信箱:wugang_123199@126.com。
