肩关节镜下肩袖缝合术后局部注射罗哌卡因对病人术后疼痛的影响

发布时间：2018-02-09 03:01

本文关键词： 肩袖缝合罗哌卡因术后疼痛中国人肩关节功能评分表　出处：《皖南医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察肩关节镜下肩袖缝合术后局部注射罗哌卡因对病人术后疼痛的影响。方法:选取我科室2015年10月—2017年03月期间行肩关节镜治疗的肩袖损伤的患者32例,按照数字表法随机的将其分为观察组和对照组各16例。观察组在肩关节镜下缝合肩袖后于盂肱关节或肩峰下间隙注射10ml罗哌卡因注射液,对照组仅注射10ml生理盐水。术后应用视觉模拟疼痛评分(VAS)和中国人肩关节功能评分表来观察患者的疼痛和肩关节功能恢复情况,同时记录两组患者不良反应发生率。结果:(1)两组患者术后24小时左右疼痛达高峰,观察组和对照组VAS评分分别为(3.3±0.8)分和(4.5±0.7)分,48小时内局部注射罗哌卡因的观察组患者其疼痛程度明显低于未局部用药的对照组患者,差异有统计学意义;72h后两组患者静息痛明显缓解,疼痛VAS评分全都在5分以下差异无统计学意义。(2)观察组患者术后24h和2d活动时疼痛VAS评分分别为(4.2±0.8)分、(5.0±0.9)分低于对照组的(5.2±0.9)分、(5.9±0.7)分,差异有统计学意义;但3d之后两组患者活动时疼痛程度无统计学差异。(3)两组患者术后肩关节功能均较术前有明显提高,且两组患者之间肩关节功能恢复情况无明显差异,P0.05,差异无统计学意义。(4)两组患者术后均未发生严重不良反应,最常见的就是恶心呕吐,且两组不良反应发生率无明显差异,P0.05,无统计学意义。结论:肩关节镜下肩袖缝合术后局部注射罗哌卡因确实能减轻患者术后早期的疼痛,尤其能减轻活动时的疼痛,且未见明显不良反应和影响患者肩关节功能恢复,是一种简单、安全、有效和方便的止痛方案,值得在临床上推广使用。
[Abstract]:Objective: to observe the effect of local injection of ropivacaine on postoperative pain after arthroscopic rotator cuff suture. Methods: 32 patients with rotator cuff injury treated by arthroscopy from October 2015 to March 2017 in our department were selected. According to the method of digital table, it was randomly divided into observation group (n = 16) and control group (n = 16). In observation group, 10ml ropivacaine injection was injected into glenohumeral joint or subacromial space after the cuff was sutured under shoulder arthroscopy. The control group was only injected with 10 ml saline. Visual analogue pain score (VAS) and Chinese shoulder function scale were used to observe the pain and the recovery of shoulder function. At the same time, the incidence of adverse reactions in both groups was recorded. Results the pain peaked 24 hours after operation in both groups. The VAS scores of the observation group and the control group were 3.3 卤0.8 and 4.5 卤0.7, respectively. The pain degree of the observation group with ropivacaine injection was significantly lower than that of the control group. The difference was statistically significant after 72 hours. There was no significant difference in pain VAS score below 5 (P < 0.05). The VAS score of pain in the observation group was 4.2 卤0.8 at 24 hours and 2 days after operation. The score was 5.0 卤0.9), which was lower than that in the control group (5.2 卤0.9) and 5.9 卤0.7, respectively, and the difference was statistically significant. However, there was no significant difference in the degree of pain between the two groups after 3 days.) the function of the shoulder joint in the two groups was significantly higher than that before operation. There was no significant difference in the recovery of shoulder joint function between the two groups (P 0.05, P 0.05, no significant difference.) there was no serious adverse reaction after operation in both groups, and the most common was nausea and vomiting. There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05). Conclusion: the local injection of ropivacaine after shoulder arthroscopic rotator cuff suture can alleviate the early postoperative pain, especially the pain during exercise. It is a simple, safe, effective and convenient analgesic scheme, which is worth popularizing in clinic.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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