目的 探討鹽酸丁丙諾啡注射液復(fù)合鹽酸羅哌卡因注射液收肌管阻滯用于前交叉韌帶重建術(shù)后鎮(zhèn)痛的臨床療效。方法 選擇2022年4~10月沈陽市骨科醫(yī)院擇期全麻下行單側(cè)前交叉韌帶重建手術(shù)治療的40例患者,按照隨機(jī)數(shù)字表法將40例患者分為對(duì)照組和治療組,每組20例。兩組均在超聲引導(dǎo)下行收肌管阻滯,對(duì)照組注射0.5%鹽酸羅哌卡因注射液20 mL+生理鹽水1 mL,治療組注射0.5%鹽酸羅哌卡因注射液20 mL+鹽酸丁丙諾啡注射液1 mL(0.15 mg)。分別記錄兩組患者術(shù)后2、6、12、24 h的VAS評(píng)分、鎮(zhèn)痛持續(xù)時(shí)間和鎮(zhèn)痛藥物用量。結(jié)果 治療組患者術(shù)后12、24 h靜息和運(yùn)動(dòng)VAS評(píng)分明顯低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組的鎮(zhèn)痛持續(xù)時(shí)間顯著長于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組術(shù)后24 h地佐辛用量明顯少于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 鹽酸丁丙諾啡注射液可作為鹽酸羅哌卡因注射液收肌管阻滯的輔助藥,為前交叉韌帶重建手術(shù)提供滿意的術(shù)后鎮(zhèn)痛,且術(shù)后并發(fā)癥少,有利于患者的術(shù)后康復(fù)。

Objective To investigate efficacy of Buprenorphine Hydrochloride Injection combined with Ropivacaine Hydrochloride Injection adductor canal block on analgesia after anterior cruciate ligament reconstruction. Methods Patients (40 cases) with selective general anesthesia for unilateral anterior cruciate ligament reconstruction surgery in Shenyang Orthopedic Hospital from April to October of 2022 were divided into control and treatment groups according to the random number table method, and each group had 20 cases. Both groups underwent ultrasound guided adductor tube block. Patients in the control group were iv administered with 20 mL 0.5% Ropivacaine Hydrochloride Injection + 1 mL normal saline, and patients in the treatment group were iv administered with 20 mL 0.5% Ropivacaine Hydrochloride Injection + 1 mL Buprenorphine Hydrochloride Injection (0.15 mg). VAS scores at rest and movement at 2, 6, 12, and 24 h after surgery in both groups, duration of analgesia, and cumulative opioid consumption at 24 h were recorded. Results The VAS scores at rest and movement in the treatment group were significantly lower than those in the control group at 12, and 24 h after operation, and the differences were statistically significant (P < 0.05). The duration of postoperative analgesia in the treatment group was significantly longer than that in the control group (P < 0.05). The use of dezocine 24 h after surgery in the treatment group was significantly lower than that in the control group (P < 0.05). Conclusion Buprenorphine Hydrochloride Injection can be used as an auxiliary drug of Ropivacaine Hydrochloride Injection for adductor block, providing satisfactory postoperative analgesia for anterior cruciate ligament reconstruction surgery, with fewer postoperative complications, which is conducive to postoperative rehabilitation of patients.

R971