| 祁富军,刘盼盼,牛江涛,闫晓东,赵建奎.罗哌卡因复合右美托咪定行收肌管阻滞预防全膝关节置换术后下肢深静脉血栓形成.[J].中南医学科学杂志.,2023,(6):953-955. |
| 罗哌卡因复合右美托咪定行收肌管阻滞预防全膝关节置换术后下肢深静脉血栓形成 |
| Ropivacaine combined with dexmedetomidine for adductor canal block to prevent deep vein thrombosis in the lower extremities after total knee arthroplasty |
| 投稿时间：2022-09-02 修订日期：2023-08-15 |
| DOI：10.15972/j.cnki.43-1509/r.2023.06.038 |
| 中文关键词: 全膝关节置换术 罗哌卡因 右美托咪定 下肢深静脉血栓形成 收肌管阻滞 [ |
| 英文关键词:TKA ropivacaine dexmedetomidine DVT adductor canal block |
| 基金项目: |
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| 中文摘要: |
| 目的探讨罗哌卡因复合右美托咪定行收肌管阻滞预防全膝关节置换术(TKA)后下肢深静脉血栓形成(DVT)的效果。 方法选取行TKA患者84例,随机均分为联合组(罗哌卡因+右美托咪定)和对照组(右美托咪定)。比较两组不同时间静息和运动疼痛评分、术后首次下床活动时间、术前和术后7天凝血功能指标、术后不良反应及DVT发生率。 结果静息状态下两组疼痛评分随时间增加逐渐降低；与术后6 h比较,运动状态下两组术后12、24、48、72 h疼痛评分均较低；且均联合组低于对照组(P＜0.05)。与术前比较,两组术后凝血酶原时间、活化部分凝血活酶时间降低,纤维蛋白原升高,且对照组较联合组显著(P＜0.05)。联合组术后首次下床活动时间和DVT发生率均低于对照组(P＜0.05)。两组不良反应发生率差异无显著性(P＞0.05)。 结论罗哌卡因复合右美托咪定行收肌管阻滞可改善TKA患者术后疼痛症状,促进康复,改善凝血功能,降低DVT发生率。 |
| 英文摘要: |
| AimTo investigate the effect of ropivacaine combined with dexmedetomidine for adductor canal block in preventing deep vein thrombosis (DVT) after total knee arthroplasty (TKA). Methods84 patients undergoing TKA were randomly divided into a combined group (ropivacaine+dexmedetomidine) and a control group (dexmedetomidine). Pain scores at rest and during exercise, time to first postoperative mobilization, coagulation function indicators 7 days before and after surgery, postoperative adverse reactions, and incidence of DVT were compared between the two groups. ResultsPain scores at rest gradually decreased with time in both groups, while pain scores during exercise at 12,24, 48, and 72 hours after surgery were lower than those at 6 hours after surgery in both groups. The pain scores were lower in the combined group compared with the control group (P＜0.05). Compared with preoperative values, prothrombin time, activated partial thromboplastin time decreased, fibrinogen increased postoperatively in both groups, but the changes were more significant in the control group than in the combined group (P＜0.05). The time to first postoperative mobilization and the incidence of DVT were lower in the combined group compared with the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). ConclusionRopivacaine combined with dexmedetomidine for myotubular block can improve postoperative pain symptoms in patients undergoing TKA. It can also promote rehabilitation, improve coagulation function and reduce the incidence of DVT. |
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