Effect of Single Femoral Nerve Block with Dexmedetomidine Combined with Low Concentration Ropivacaine on Knee Arthroplasty in Elderly Patients
Objective To investigate the effect of single femoral nerve block with dexmedetomidine combined with low concentration ropivacaine on postoperative analgesia and postoperative muscle strength recovery in elderly patients after knee arthroplasty.Methods A total of 60 patients undergoing total knee arthroplasty(TKA)under general anesthesia with laryngeal mask intubation from March 2020 to September 2021 in Shenzhen Longgang Orthopaedics Hospital were selected and randomly divided into experimental group(DR group)and control group(R group),with 30 patients in each group.DR group and R group were treated with 0.15％ropivacaine+1 μg/kg dexmedetomidine and 0.15％ropivacaine for ultrasound-guided femoral nerve block,respectively.Postoperative patient-controlled intravenous analgesia(PCIA)was performed in both groups.The pain degree(VAS)and quadriceps muscle strength at different time points(4,8,12,18,24,48 h)after operation were compared between the two groups.The first pressing time of PCIA after operation,the times of PCA pressing at each time interval within 48 h after operation,related complications and adverse reactions were recorded in the two groups.Results The VAS score of resting state and motion state at 8,12 and 24 h after operation in DR group was lower than that in R group(P＜0.05).The first PCA pressing time of DR group was(5.64±1.73)h,which was longer than(3.15±1.52)h of R group,and the difference was statistically significant(P＜0.05).The times of PCA pressing at 4-8 h,8-12 h and 12-24 h after operation in DR group were less than those in R group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Compared with ropivacaine alone,dexmedetomidine combined with low concentration ropivacaine can enhance the block effect,prolong the postoperative analgesia time,have less effect on the recovery of postoperative muscle strength,and will not increase the adverse reactions,which can provide better analgesic effect for TKA patients.
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维普
