Clinical Efficacy Of Dexmedetomidine Combined With Ropivacaine After Total Knee Arthroplasty

Objective: To investigate the effect of different doses of dexmeidine combined with ropivacaine for knee arthroplasty,to observe postoperative analgesia,sleep condition and muscle strength recovery of patients after knee arthroplasty.Methods: 90 patients in Hospital of Qingdao University scheduled for selective knee arthroplasty surgery were randomly divided into three groups,30 patients in each group.The day before the surgery,Athens Insomnia Scale score of second days for patients with knee arthroplasty(AIS insomnia score)and MMSE score were recorded.Patients connected ECG,supine position and limb swing 15 degrees,giving the puncture site iodophor disinfection.Ultrasound guided femoral nerve block in the affected side:Ropivacaine(100mg)was diluted into 25 ml in group G1(n=30),ropivacaine(100mg)+0.5ug/kg dexmedetomidine diluted into 25 ml in group G2(n=30)and ropivacaine(100mg)+1ug /kg dexmedetomidine diluted into 25 ml in group G3(n=30).VIS before surgery and VIS of 1 day and 2 days after surgery,Ramsay sedation scores,PONV scoring and muscle strength grades at 12,24,48 hours were recorded.All data were processed by SPSS 21 statistical software.The effects of dexmedetomidine combined with ropivacaine on analgesia,sleep and muscle strength recovery in patients undergoing total knee arthroplasty were studied.Results: There was no significant difference in age,sex,weight,educational level,ASA grade and MMSE score in the three groups.On the 1 day after operation,the AIS score was analyzed by repeated analysis of variance.The difference between the three groups was statistically significant(P < 0.05),and each 2 groups were further compared.The score of AIS in group G3 was significantly lower than that in group G1 and G2(P <0.05).There was no significant difference between the three groups at 2 day after the operation(P>0.05).There was a significant difference in VAS scores between threegroups after 12 h and 24h(P < 0.05).Further each 2 groups comparison,VAS scores in group G3 and G2 were significantly lower than those in G1 group,with statistically significant difference(P < 0.05).There was a significant difference in the recovery of muscle strength between the three groups(P < 0.05).Further comparison,the recovery of muscle strength in group G3 was significantly higher than that in group G 1 and G2,and the difference was statistically significant(P < 0.05).After 12 h,24h and 48 h,there was no statistical significance in three groups of RAMSAY,PONV(P > 0.05).Conclusion: Ropivacaine(100mg)+1ug /kg dexmedetomidine diluted into 25 ml can reduce postoperative pain,improve postoperative sleep,shorten the braking time after surgery,and be beneficial to patients with early functional exercise,and yet found its adverse reactions.