Comparison of different anesthesia drugs in hip joint replacement

doi:10.3969/j.issn.2095-4344.2014.53.007

Abstract

Abstract:

BACKGROUND: There are many anesthesia drugs used for hip joint replacement, but the choice remains controversial.
OBJECTIVE: To compare the application effect of different anesthesia drugs in patients underwent hip joint replacement.
METHODS: We selected 81 patients candidated for hip joint replacement in Chongming Branch, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, and randomly divided them into three groups. Patients in the three groups were anesthetized with 0.75% ropivacaine, 0.5% bupivacaine, and 2% lidocaine, respectively. Patient’s anesthetic effect and adverse reaction were monitored and recorded.
RESULTS AND CONCLUSION: Compared with the bupivacaine and lidocaine groups, the mean arterial pressure and heart rate had more remarkable stability in the ropivacaine group; the mean arterial pressure and heart rate increased significantly before skin incision and 20 minutes after skin incision (P < 0.05); the sensory block onset time, block plane fixed time and anesthesia duration were longer, and the highest block plane was the largest (P < 0.05); Bromage scores showed significant difference (P < 0.05). The saturation of blood oxygen showed no significant difference among three groups (P > 0.05) and postoperative adverse reaction was good. The results showed that, ropivacaine, bupivacaine and lidocaine are good anesthesia drugs for hip joint replacement, with good overall effect and few adverse reactions. Compared with bupivacaine and lidocaine, ropivacaine anesthesia achieves better hemodynamic stability, better sensory blocking perfect, less motor block effect, and less adverse reaction.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: tissue engineering, nerve block, heart rate, hip joint

CLC Number:

R318

Zhu Wei-bing. Comparison of different anesthesia drugs in hip joint replacement[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(53): 8565-8569.

Figures/Tables 1

2.1 参与者数量分析所选81例患者研究期间均无退出，均进入结果分析。 2.2 各组患者基线资料分析由表1可得，3组患者在性别、年龄、身高、体质量、美国麻醉师协会评估标准(ASA分级)、患病侧、病程的比较差异无显著性意义(P > 0.05)，则说明3组患者在一般资料上有可比性。 2.3 各组患者麻醉后不同时间点平均动脉压、心率以及血氧饱和度的比较通过监测与记录手术前、切皮前、切皮后20 min以及手术结束时3组患者平均动脉压、心率以及血氧饱和度情况。总体结果显示，3组患者在平均动脉压、心率以及血氧饱和度上表现都比较好。相对布比卡因组与利多卡因组，罗哌卡因组患者的平均动脉压与心率具有更加显著的稳定性。特别是在切皮前、切皮后20 min，相对罗哌卡因组，布比卡因组与利多卡因组患者的平均动脉压与心率下降较为显著(P < 0.05)；而布比卡因组与利多卡因组患者平均动脉压与心率差异无显著性意义(P > 0.05)。 3组患者的血氧饱和度差异无显著性意义(P > 0.05)。见表2。 2.4 各组患者麻醉后感觉神经阻滞效果的比较相对布比卡因组与利多卡因组，罗哌卡因组患者在感觉阻滞起效的时间上较长(P < 0.05)。相对布比卡因组与利多卡因组，罗哌卡因组患者阻滞平面固定的时间长、最高阻滞平面大、麻醉过程持续的时间长(P < 0.05)。布比卡因组与利多卡因组患者用药麻醉后在感觉阻滞起效的时间、阻滞平面固定的时间、最高阻滞平面以及麻醉过程持续的时间上相比差异无显著性意义(P > 0.05)。见表3。通过对3组患者运动神经阻滞效果进行Bromage评级比较可知，3组患者运动神经阻滞效果总体都比较好。相对布比卡因组与利多卡因组，罗哌卡因组患者评级效果更好，具有显著的优势(P < 0.05)。布比卡因组与利多卡因组患者评级效果差异无显著性意义(P > 0.05)。 2.5 各组患者麻醉中不良反应情况的比较通过对3组患者麻醉后的不良反应情况进行统计分析可得，布比卡因组有1例(3.8%)出现了低血压现象，利多卡因组有1例(3.8%)出现了心律失常现象，但是情况都不严重，都得到了及时、有效的控制，3组患者在术中不良反应方面总体表现都比较好。3组患者在恶心、呕吐、头痛、呼吸抑制、低血压、心律失常等不良反应方面差异无显著性意义(P > 0.05)。"

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