|
|
Application of advanced butorphanol combined with ultrasound guided multi-point block in knee replacement |
WANG Xin, WANG Lu, WANG Kai, FU Jie |
Xuzhou Central Hospital, Xuzhou 221009, China |
|
|
Abstract Objective To explore the application of advanced butorphanol combined with ultrasound guided multi-point block in knee replacement. Methods 108 patients who underwent knee replacement in our hospital from January 2020 to July 2022 were selected and divided into two groups (54 cases in the study group and 54 cases in the control group). Both groups were anesthetized by multi-point nerve block under the guidance of ultrasound, and the study group intravenous injection 20μg/kg butorphanol at 10 minutes before nerve block, but the equal amount of normal saline was implemented in the control group. The heart rate (HR) and mean arterial pressure (MAP) were compared before butorphanol injection (T0), 10min after butorphanol injection (T1), 15min after multi-point block (T2), 30min after multi-point block (T3) and at the end of operation (T4), and the onset and duration of pain nerve block and use of other anesthetics during operation were compared, and the scores of visual analogue scale (VAS) and Bruggrmann comfort scal (BCS) at different time points after surgery were compared, and the adverse events during and after operation were also compared. Results The HR and MAP at T1, T2 and T3 in the study group were lower than T0, which at T2 were lower than T1, and there was no statistically significant difference in pairs at other time points. The HR and MAP at T2 and T3 in the control group were lower than those at T0 and T1, but there was no statistically significant difference in pairs at other time points. There was no significant difference in HR and MAP between the two groups at each time point. Compared with the control group, the onset time of pain nerve block in the study group was short, and the duration of pain nerve block was long, while the use rate of fentanyl during operation was low. Compared with the control group, the resting VAS scores at 2h and 4h after operation in the study group were lower, while the BCS scores were higher. The rate of restlessness in the study group was lower compared with control group. Conclusion In the knee joint replacement operation, the use of butorphanol in advance combined with multi-point block under ultrasound guidance has stable blood flow during the operation and good analgesic effect, and it can reduce the short-term pain of patients after the operation, improve their comfort, and reduce restlessness during the awakening period.
|
Received: 21 November 2022
|
|
|
|
|
[1] Siddiqui R, Bansal S, Puri A, et al.A Comparative Study of Ultrasound-Guided Continuous Adductor Canal Block With Ultrasound-Guided Continuous Femoral Nerve Block in Unilateral Total Knee Arthroplasty for Limb Mobilization and Analgesic Efficacy[J]. Cureus, 2022, 14(3): e22904. [2] Kertkiatkachorn W, Kampitak W, Tanavalee A, et al. Adductor Canal Block Combined With iPACK (Interspace Between the Popliteal Artery and the Capsule of the Posterior Knee) Block vs Periarticular Injection for Analgesia After Total Knee Arthroplasty: A Randomized Noninferiority Trial[J]. J Arthroplasty, 2021, 36 (1): 122-129. e1. [3] Kale SG, Shetty A, Moin A, et al.Comparative Evaluation of Preemptive Analgesia of Dextromethorphan and Ibuprofen in Third Molar Surgeries[J]. Ann Maxillofac Surg, 2020, 10(2): 312-319. [4] 李晓青, 曹雪鹏, 朱伟超, 等. 布托啡诺超前镇痛对肺癌患者胸腔镜肺叶切除术围术期应激反应及术后疼痛的影响[J]. 肿瘤研究与临床, 2021, 33(1): 28-32. [5] 唐雯, 曾志英, 周杰. 右美托咪定滴鼻联合布托啡诺超前镇痛在腹腔镜胆囊切除术中的应用[J]. 湖南师范大学学报 (医学版) , 2021, 18(4): 21-24. [6] Li Gen, Walco Jeremy P, Mueller Dorothee A, et al.Reliability of the ASA physical status classification system in predicting surgical morbidity: a retrospective analysis[J]. J Med Syst, 2021, 45(9): 83. [7] Carlew AR, Smith EE, Goette W, et al.Montreal Cognitive Assessment (MoCA) scores in medically compromised patients: A scoping review[J]. Health Psychol, 2021, 40(10): 717-726. [8] 严广斌. 视觉模拟评分法[J]. 中华关节外科杂志 (电子版) , 2014, 8(2): 34. [9] 宁猛, 汤黎黎, 李伟, 等. 超声引导胸腰筋膜间平面阻滞在单节段腰椎融合术围手术期的镇痛效果及安全性[J]. 临床骨科杂志, 2020, 23(6): 821-824. [10] Alghadir AH, Iqbal ZA, Anwer S, et al.Comparison of simultaneous bilateral versus unilateral total knee replacement on pain levels and functional recovery[J]. BMC Musculoskelet Disord, 2020, 21(1): 246. [11] 代晨旭, 蔡宁, 官双双, 等. 腰丛联合坐骨神经阻滞与股-闭孔-坐骨神经阻滞在全膝关节置换术的临床效果比较[J]. 解放军预防医学杂志, 2019, 37(8): 55-56. [12] Wang Q, Yang Y, Yang Z, et al.Analgesic Effects of Ultrasound-Guided Iliohypogastric/Ilioinguinal Nerve Block Combined with Lateral Femoral Cutaneous Nerve Block in Total Hip Arthroplasty via Direct Anterior Approach: A Retrospective Cohort Study[J]. Orthop Surg, 2021, 13(3): 920-931. [13] 陈涛, 吴奕涵, 敖保林, 等. 布托啡诺超前镇痛联合颈丛神经阻滞中加入右美托咪定在甲状腺手术中的应用[J]. 山东医药, 2018, 58(18): 80-84. [14] 赵永杰, 吴永伟, 屈翰. 布托啡诺联合右美托咪定超前镇痛对乳腺癌保乳手术患者术后镇痛的效果观察[J]. 实用癌症杂志, 2021, 36 (11): 1810-1812+1817. [15] Zhu RY, Xiang SQ, Chen DR.Combined lumbar muscle block and perioperative comprehensive patient-controlled intravenous analgesia with butorphanol in gynecological endoscopic surgery[J]. World J Clin Cases, 2021, 9(34): 10540-10548. [16] 刘燃, 宋莺春, 董家玮, 等. 地佐辛和布托啡诺在胫腓骨骨折手术患者中的超前镇痛疗效观察[J]. 解放军预防医学杂志, 2019, 37(4): 98-99. [17] 高蓝天, 李春萍. 布托啡诺联合右美托咪定超前镇痛对于麻醉苏醒期躁动的影响[J]. 中国实验诊断学, 2020, 24(3): 418-421. |
|
|
|