肩峰下镇痛泵联合氟比洛芬酯用于肩关节镜术后镇痛的随机对照研究

发布时间：2018-06-04 04:52

本文选题：肩峰下 + 自控镇痛　；参考：《中国微创外科杂志》2017年08期

【摘要】：目的评价肩峰下置罗哌卡因镇痛泵联合静脉注射氟比洛芬酯用于肩关节镜术后康复镇痛效果。方法 2013年4月~2015年9月105例肩关节镜术后随机分为3组进行镇痛,分别为肩峰下置镇痛泵镇痛组(S组),罗哌卡因150mg肩峰下置自控镇痛泵;氟比洛芬酯组(I组),静脉给予氟比洛芬酯100 mg;肩峰下置镇痛泵联合静脉氟比洛芬酯注射镇痛组(S+I组),联合前二者用药,术后进行康复锻炼。观察患者不良反应发生及切口情况,进行术后8 h和1、3、14 d疼痛数字分级法(numeric pain intensity scale,NPIS)评分和肩关节功能评分(American shoulder and elbow surgeons scale,ASES)。结果3组术后8 h和1、3、14 d NPIS评分有显著性差异(P=0.000),其中S+I组明显低于S组和I组(P0.05),S组明显低于I组(P0.05)。3组间术后8 h、1 d、3 d、14 d ASES评分有显著性差异(P=0.000),其中S+I组明显优于S组和I组(P0.05),S组优于I组(P0.05)。3组不良反应为恶心、呕吐,发生率为16.2%(17/105)),S组明显低于S+I组和I组(χ~2=4.590,P=0.032;χ~2=4.590,P=0.032)。术后2周随访患者肩关节切口无感染和红肿。结论肩峰下置罗哌卡因镇痛泵联合静脉注射氟比洛芬酯安全,肩外科手术后及早期康复锻炼镇痛效果好,无感染,不良反应发生率低。
[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.
【作者单位】：北京大学深圳医院运动医学科;
【分类号】：R687.4

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