伴有心脏疾患病人全膝关节置换术中关节周围大剂量布比卡因注射镇痛的疗效和安全性Effect and safety of periarticular high-dose bupivacaine injections during total knee arthroplasy in patients with heart diseases
何川;冯建民;刘志宏;王毅;杨庆铭;
摘要(Abstract):
[目的]研究人工全膝关节置换术(TKA)中关节周围软组织注射含有大剂量布比卡因的混合药物进行术后镇痛对于伴有心脏疾患病人的临床疗效以及有无毒副反应。[方法]35例准备进行单侧TKA的骨关节炎病人根据是否伴发心脏疾患分为心脏病组(12例)和非心脏病组(23例)。在围手术期所有患者按相同镇痛方案治疗,术中关节周围注射"Ranawat Cocktail"镇痛药液(包含0.75%布比卡因250 mg,吗啡4 mg,肾上腺素0.3 mg,甲基强的松龙40 mg,头孢唑啉0.5 g,生理盐水57 ml)。记录患者术后疼痛VAS评分、满意度、膝关节活动度、主动直腿抬高时间、伤口并发症、术后住院天数、心电图异常及心血管并发症等。[结果]两组病人术后VAS评分、满意度、膝关节活动度、主动直腿抬高时间和术后住院天数均无统计学差异,所有病人无伤口并发症以及心血管并发症发生。[结论]在TKA术中,关节周围注射含有大剂量布比卡因的"Ranawat Cocktail"混合药物对伴发心脏疾患的病人同样可以提供很好的术后镇痛效果,并且具有良好的安全性。
关键词(KeyWords): 全膝置换术;关节周围注射;布比卡因;心脏病;疼痛
基金项目(Foundation): 国家自然科学基金资助项目(编号:81071473)
作者(Author): 何川;冯建民;刘志宏;王毅;杨庆铭;
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DOI:
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