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罗哌卡因联合羟考酮用于髋关节置换术患者髂筋膜神经阻滞镇痛的有效性和安全性
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| 篇名： | 罗哌卡因联合羟考酮用于髋关节置换术患者髂筋膜神经阻滞镇痛的有效性和安全性 |
| TITLE： | Efficacy and safety of ropivacaine combined with oxycodone for iliac fascia nerve block analgesia in patients undergoing hip replacement |
| 摘要： | 目的 探讨罗哌卡因联合羟考酮用于髋关节置换术患者髂筋膜神经阻滞镇痛的有效性和安全性。方法选取2023年10月至2024年4月于恩施土家族苗族自治州中心医院接受髋关节置换术的患者66例，将其随机分为观察组和对照组，每组33例。麻醉诱导前行超声引导下髂筋膜神经阻滞，观察组患者采用0.33%罗哌卡因+0.1mg/kg羟考酮注射液混合液30mL，对照组患者采用0.33%罗哌卡因注射液30mL。记录两组患者术后首次补救镇痛时间、术后24h补救镇痛药物总量、感觉阻滞与运动阻滞起效与维持时间、满意度、数字分级评分法（NRS）疼痛评分、Ramsay镇静评分、肌力评分、心率（HR）、平均动脉压（MAP）、脉搏血氧饱和度（SpO2）、睡眠评分、焦虑评分，以及不良反应发生情况。结果与对照组比较，观察组患者术后首次补救镇痛时间显著延长，术后24h补救镇痛药物总量显著减少，感觉阻滞起效时间显著缩短、维持时间显著延长，满意度评分显著提高，髂筋膜神经阻滞后NRS疼痛评分、HR、MAP和术后24、48h焦虑评分、睡眠评分显著降低（P＜0.05）。在安全性方面，两组均有患者术后出现高血压、恶心、呕吐、头晕等不良反应，但两组之间总的不良反应发生率比较，差异无统计学意义（P＞0.05）。结论羟考酮联合罗哌卡因用于髋关节置换术患者髂筋膜神经阻滞镇痛，其有效性和安全性均较高，可显著延长罗哌卡因的镇痛时间，减少术后镇痛药物总量，改善患者睡眠质量，促进患者快速康复。 |
| ABSTRACT： | OBJECTIVE To investigate the efficacy and safety of ropivacaine combined with oxycodone for the analgesia of iliac fascia nerve block in patients undergoing hip replacement. METHODS Sixty-six patients who underwent hip replacement at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from October 2023 to April 2024 were selected and randomly divided into observation group and control group， with 33 cases in each group. Before induction of anesthesia， ultrasound-guided iliac fascial nerve block was performed. Patients in the observation group were treated with 0.33% ropivacaine+0.1 mg/kg oxycodone injection mixture 30 mL， and patients in the control group were treated with 0.33% ropivacaine injection 30 mL. The time of first postoperative rescue analgesia， 24 h postoperative analgesic drug consumption， sensory block and motor block effective and maintenance time， satisfaction degree， numerical rating scale （NRS） pain score， Ramsay sedation score， muscle strength score， heart rate （HR）， mean arterial pressure （MAP）， oxygen saturation（SpO2）， sleep score， anxiety score， and the occurrence of adverse reactions in the two groups were all recorded. RESULTS Compared with the control group， the first rescue analgesia time after operation was significantly prolonged in the observation group， and 24 h postoperative analgesic drug consumption after operation decreased； the effective time of sensory block was significantly shortened， and the maintenance time of sensory block was significantly prolonged， and the satisfaction score was higher； the NRS pain score after iliac fascia nerve block was lower， HR and MAP were lower， and the anxiety score and sleep score 24 and 48 h after operation were lower （P＜0.05）. In terms of safety， patients in both groups had adverse reactions after operation， such as hypertension， nausea， vomiting， and dizziness， but there was no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS Oxycodone combined with ropivacaine shows good efficacy and safety for iliac fascial nerve block analgesia in patients undergoing hip replacement， can significantly prolong the analgesic time of ropivacaine， reduce postoperative analgesic drug consumption， improve the sleep quality of patients， and promote the rapid recovery of patients. |
| 期刊： | 2025年第36卷第08期 |
| 作者： | 张欣玥；何亚鹏；朱贤林；刘伟清；张毅；万正嵩；姚娜娜；牟俊英 |
| AUTHORS： | ZHANG Xinyue， HE Yapeng，ZHU Xianlin，LIU Weiqing，ZHANG Yi，WAN Zhengsong，YAO Nana，MOU Junying |
| 关键字： | 髋关节置换；髂筋膜神经阻滞；羟考酮；罗哌卡因；镇痛 |
| KEYWORDS： | hip replacement； iliac fascia nerve block； oxycodone； ropivacaine； analgesia |
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