首页|切口周围局部浸润麻醉对拇外翻术后镇痛效果的影响

切口周围局部浸润麻醉对拇外翻术后镇痛效果的影响

扫码查看
目的:探讨切口周围局部浸润麻醉对拇外翻术后镇痛效果的影响。方法:选取 2022 年 3月至2022 年7 月于首都医科大学附属北京同仁医院足踝外科中心行拇外翻截骨矫形手术的患者 70例,根据术后不同镇痛方式随机分为试验组和对照组,每组35 例。对照组术后给予静脉镇痛泵镇痛,试验组在术后静脉镇痛泵镇痛基础上给予手术切口周围 0。375%盐酸罗哌卡因局部浸润麻醉,比较两组术后6、18、24 及48h的疼痛视觉模拟量表(visual analogue scale,VAS)评分、术后止疼药物使用剂量、静脉镇痛泵的按压次数、术后伤口近期并发症发生率及患者术后疼痛控制满意度。结果:试验组术后 6、18 及24h的VAS疼痛评分分别为1。17±0。954、1。80±0。868、1。74±1。172,低于对照组的 2。57±2。160、4。27±1。886、3。66±1。984,差异有统计学意义(P<0。05)。试验组术后 48h 的VAS 评分为 1。26±0。980,对照组为1。69±1。078,两组比较无统计学差异(P>0。05)。对照组术后氨酚氢考酮片、塞来昔布胶囊、氟比洛芬酯注射液等止疼药物使用剂量、静脉镇痛泵的按压次数分别为 603。43±282。811mg、285。71±176。806mg、40。87(0,150)mg、9(6,10。25),高于试验组的278。14±214。655mg、205。71±141。302mg、30。13(0,400)mg、4。5(3,6。75),差异有显著性(P<0。05)。试验组术后伤口近期并发症切口渗液、脂肪液化、切口红肿的发生率为5。71%、2。85%、8。57%,与对照组的 8。57%、0%、2。85%比较差异无统计学意义(P>0。05)。试验组术后疼痛满意度高于对照组,差异有统计学意义(P<0。05)。结论:切口周围局部浸润麻醉可以降低拇外翻患者术后的疼痛程度、减少术后止疼药物的使用剂量及静脉镇痛泵的按压次数,提高患者疼痛控制满意度,同时不增加术后伤口近期并发症的发生率,值得临床推广应用。
The Effect of Local Infiltration Anesthesia around the Incision on Postoperative Analgesic Effect of Hallux Valgus Surgery
Objective:To explore the effect of local infiltration anesthesia around the incision on postop-erative pain relief after hallux valgus surgery.Methods:From March 2022 to July 2022,70 patients undergo-ing hallux valgus osteotomy and orthopedic surgery at the Foot and Ankle Surgery Center of Beijing Tongren Hospital affiliated to Capital Medical University were randomly selected and divided into experimental group and control group according to different postoperative analgesia methods,with 35 patients in each group.The control group was given intravenous analgesia pump analgesia after surgery,while the experimental group was given local infiltration anesthesia with 0.375%ropivacaine around the surgical incision on the basis of intrave-nous analgesia pump analgesia after surgery.The scores of VAS at 6,18,24 and 48 hours after surgery,the dosage of postoperative painkillers,the number of compressions of the intravenous analgesic pump the inci-dence of recent complications after surgery,and the satisfaction of patients with postoperative pain control were compared between the two groups.Results:The VAS pain scores in the experimental group were 1.17±0.954,1.80±0.868,and 1.74±1.172 at 6,18 and 24 hours after surgery,respectively,lower than those 2.57±2.160,4.27±1.886,and 3.66±1.984 in the control group,with a statistically significant difference(P<0.05).The VAS score at 48 hours after operation in the experimental group was 1.26±0.980,and 1.69±1.078 in the control group,there was no significant difference between the two groups(P>0.05).The postoperative analgesic doses of hydrocortisone,celecoxib,flurbiprofen axetil and number of compressions of the intravenous analgesic pump in the control group were 603.43±282.811mg,285.71±176.806mg,40.87(0,150)mg,and 9(6,10.25)respectively,which were significantly higher than those in the experimental group(278.14±214.655mg,205.71±141.302mg,30.13(0,400)mg)and 4.5(3,6.75),with a significant difference(P<0.05).The incidence of recent complications such as incision effusion,fat liquefaction,and incision redness and swelling in the experimental group were 5.71%,2.85%,and 8.57%,respectively.there was no statisti-cally significant difference compared to 8.57%,0%,and 2.85%in the control group(P>0.05).The postop-erative pain satisfaction of the experimental group was higher than that of the control group,with a statistically significant difference(P<0.05).Conclusion:Local infiltration anesthesia around the incision can reduce the degree of postoperative pain in patients with hallux valgus,reduce the dosage of postoperative pain relievers and the number of compressions of the intravenous analgesic pump,improve patient satisfaction with pain con-trol,and do not increase the incidence of recent complications after surgery.It is worthy of clinical promotion and application.

Hallux valgusAround the incisionLocal infiltration anesthesiaPostoperativePain

聂志红、王巍、张明珠、张琳、王克涛

展开 >

首都医科大学附属北京同仁医院足踝外科中心, 北京 100176

拇外翻 切口周围 局部浸润麻醉 术后 疼痛

国家自然科学基金青年科学基金首都医科大学科研培育基金

82302692PYZ22099

2024

河北医学
河北省医学会

河北医学

CSTPCD
影响因子:1.915
ISSN:1006-6233
年,卷(期):2024.30(3)
  • 11