目的 探讨盐酸丁丙诺啡注射液复合盐酸罗哌卡因注射液收肌管阻滞用于前交叉韧带重建术后镇痛的临床疗效。方法 选择2022年4~10月沈阳市骨科医院择期全麻下行单侧前交叉韧带重建手术治疗的40例患者,按照随机数字表法将40例患者分为对照组和治疗组,每组20例。两组均在超声引导下行收肌管阻滞,对照组注射0.5%盐酸罗哌卡因注射液20 mL+生理盐水1 mL,治疗组注射0.5%盐酸罗哌卡因注射液20 mL+盐酸丁丙诺啡注射液1 mL(0.15 mg)。分别记录两组患者术后2、6、12、24 h的VAS评分、镇痛持续时间和镇痛药物用量。结果 治疗组患者术后12、24 h静息和运动VAS评分明显低于对照组,差异有统计学意义(P<0.05)。治疗组的镇痛持续时间显著长于对照组,差异有统计学意义(P<0.05)。治疗组术后24 h地佐辛用量明显少于对照组,差异有统计学意义(P<0.05)。结论 盐酸丁丙诺啡注射液可作为盐酸罗哌卡因注射液收肌管阻滞的辅助药,为前交叉韧带重建手术提供满意的术后镇痛,且术后并发症少,有利于患者的术后康复。

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.

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