本文選題：羅哌卡因　切入點(diǎn)：連續(xù)股神經(jīng)阻滯　出處：《延邊大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:近年來(lái),隨著神經(jīng)阻滯精確定位技術(shù)的發(fā)展,連續(xù)神經(jīng)阻滯技術(shù)越來(lái)越多的應(yīng)用在患者的術(shù)后鎮(zhèn)痛當(dāng)中。本研究擬觀察不同配比的羅哌卡因行連續(xù)股神經(jīng)阻滯鎮(zhèn)痛在全膝關(guān)節(jié)置換術(shù)后早期功能康復(fù)鍛煉過(guò)程中的療效,尋求合適的給藥濃度,為臨床選擇適宜的羅哌卡因濃度提供參考依據(jù)。方法:選擇ASA分級(jí)Ⅰ～Ⅱ級(jí)行單側(cè)全膝關(guān)節(jié)置換術(shù)患者60例,隨機(jī)分為羅哌卡因高濃度組(0.30%)和低濃度組(0.15%),每組30例。全部患者均采用喉罩維持呼吸全身麻醉,術(shù)后實(shí)施連續(xù)股神經(jīng)阻滯進(jìn)行鎮(zhèn)痛。觀察不同時(shí)間點(diǎn)(6h、12h、24h、48h、72h)的靜息、(24h、48h、72h)主動(dòng)和(72h)持續(xù)被動(dòng)功能訓(xùn)練時(shí)的視覺(jué)模擬(VAS)疼痛評(píng)分,分析開始下床活動(dòng)時(shí)間、肌力分級(jí)和并發(fā)癥發(fā)生率。結(jié)果:高濃度組在術(shù)后12h、24h、48h、72h的靜息、主動(dòng)和持續(xù)被動(dòng)功能訓(xùn)練時(shí)的VAS疼痛評(píng)分均顯著低于低濃度組(P0.05),術(shù)后6h RVAS疼痛評(píng)分兩組間無(wú)顯著差異(1.2±1.0vs1.4土 1.1,P0.05);兩組患者下床活動(dòng)時(shí)間無(wú)顯著差異(24±2hvs26±3h,P0.05);兩組患者的術(shù)后24-72h肌力評(píng)分大于三級(jí);兩組術(shù)中和術(shù)后均未發(fā)生并發(fā)癥。結(jié)論:0.3%羅哌卡因行連續(xù)股神經(jīng)阻滯對(duì)全膝關(guān)節(jié)置換術(shù)患者術(shù)后早期功能康復(fù)鍛煉時(shí)不影響肌力,同時(shí)能提供比0.15%羅哌卡因更好的鎮(zhèn)痛效果,使患者更為舒適,更適合臨床應(yīng)用。
[Abstract]:Objective: in recent years, with the development of precise localization technology of nerve block, Continuous nerve block technique is more and more used in postoperative analgesia of patients. This study aims to observe the effect of continuous femoral nerve block analgesia with ropivacaine in the early functional rehabilitation after total knee arthroplasty. Methods: 60 patients with ASA grade 鈪，

本文編號(hào)：1578205