本文選題：肩峰下 + 自控鎮(zhèn)痛��； 參考：《中國(guó)微創(chuàng)外科雜志》2017年08期

【摘要】：目的評(píng)價(jià)肩峰下置羅哌卡因鎮(zhèn)痛泵聯(lián)合靜脈注射氟比洛芬酯用于肩關(guān)節(jié)鏡術(shù)后康復(fù)鎮(zhèn)痛效果。方法 2013年4月~2015年9月105例肩關(guān)節(jié)鏡術(shù)后隨機(jī)分為3組進(jìn)行鎮(zhèn)痛,分別為肩峰下置鎮(zhèn)痛泵鎮(zhèn)痛組(S組),羅哌卡因150mg肩峰下置自控鎮(zhèn)痛泵;氟比洛芬酯組(I組),靜脈給予氟比洛芬酯100 mg;肩峰下置鎮(zhèn)痛泵聯(lián)合靜脈氟比洛芬酯注射鎮(zhèn)痛組(S+I組),聯(lián)合前二者用藥,術(shù)后進(jìn)行康復(fù)鍛煉。觀察患者不良反應(yīng)發(fā)生及切口情況,進(jìn)行術(shù)后8 h和1、3、14 d疼痛數(shù)字分級(jí)法(numeric pain intensity scale,NPIS)評(píng)分和肩關(guān)節(jié)功能評(píng)分(American shoulder and elbow surgeons scale,ASES)。結(jié)果3組術(shù)后8 h和1、3、14 d NPIS評(píng)分有顯著性差異(P=0.000),其中S+I組明顯低于S組和I組(P0.05),S組明顯低于I組(P0.05)。3組間術(shù)后8 h、1 d、3 d、14 d ASES評(píng)分有顯著性差異(P=0.000),其中S+I組明顯優(yōu)于S組和I組(P0.05),S組優(yōu)于I組(P0.05)。3組不良反應(yīng)為惡心、嘔吐,發(fā)生率為16.2%(17/105)),S組明顯低于S+I組和I組(χ~2=4.590,P=0.032;χ~2=4.590,P=0.032)。術(shù)后2周隨訪患者肩關(guān)節(jié)切口無感染和紅腫。結(jié)論肩峰下置羅哌卡因鎮(zhèn)痛泵聯(lián)合靜脈注射氟比洛芬酯安全,肩外科手術(shù)后及早期康復(fù)鍛煉鎮(zhèn)痛效果好,無感染,不良反應(yīng)發(fā)生率低。
[Abstract]:Objective to evaluate the effect of ropivacaine analgesia pump under acromion and intravenous flurbiprofen for postoperative analgesia after shoulder arthroscopy. Methods from April 2013 to September 2015, 105 cases of shoulder arthroscopic analgesia were randomly divided into 3 groups: group S (group S) with subacromian analgesia pump, and group S (group S) with ropivacaine 150mg subacromial analgesia pump. Flurbiprofen group (group I) was given flurbiprofen (100 mg) intravenously, and group S (group S) received analgesic pump under shoulder and intravenous injection of flurbiprofen (group I). The incidence of adverse reactions and incision were observed, and the scores of pain intensity scaleNIS and the function of shoulder joint were evaluated by numerical pain intensity scaleNIS and American shoulder and elbow surgeons scaleASESN at 8 h and 1 day 3 and 14 d after operation. Results there was a significant difference in NPIS scores between the 3 groups at 8 h and 1 day 314 d after operation. The ASES score of S I group was significantly lower than that of S group and I group P 0.05 and S group was significantly lower than that of I group P 0.05 and P 0. 05%. 3 days after operation, there was a significant difference in ASES score between group I and group I (P 0. 000), and there was a significant difference in ASES score between group I and group I (P 0. 000). The adverse reactions in group S were better than those in group S and group I, and the adverse reactions in group S were better than those in group I, and the adverse reactions were nausea. The incidence of vomiting in group S was significantly lower than that in group I and group I (蠂 2 = 4.590), and the incidence of vomiting was significantly lower in group S (17 / 105) than that in group I (蠂 ~ 2 = 4.590), P = 0.032, 蠂 ~ 2 = 4.590 / P = 0.032. The patients were followed up 2 weeks after operation without infection or swelling in the shoulder joint incision. Conclusion it is safe to put ropivacaine under shoulder and intravenous injection of flurbiprofen ester. The analgesic effect is good after shoulder surgery and early rehabilitation exercise. There is no infection and the incidence of adverse reaction is low.
【作者單位】： 北京大學(xué)深圳醫(yī)院運(yùn)動(dòng)醫(yī)學(xué)科;
【分類號(hào)】：R687.4

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