The Effect Of Intra-articular Injection Of Ropivacaine Combining With Neostigmine And Dexamethasone In Shoulder Joint On Postoperative Analgesia After Rotator Cuff Repair

Objective:The aim of the study was to investigate the effect of intraarticular injection of ropivacaine combined with neostigmine and dexamethasone on postoperative analgesia and stress response after arthroscopic rotator cuff repair.Methods:Ninety-six patients were included in this study and patients were divided into three groups through sealed envelope method.Group A received intra-articular injection of 40 mg ropivacaine and 500 μg neostigmine;Group B was injected with 40 mg ropivacaine and 5 mg dexamethasone;Group C received intra-articular injection of 40 mg ropivacaine combined with 500μg neostigmine and 5 mg dexamethasone.The drugs were diluted into 20 ml before injection.Patients were all anesthetized by a anesthesiologist and endotracheal intubation and inhalation combined with general anesthesia were used intraoperatively.No analgesics were added after surgery.The extent of pain was evaluated at different time points included pre-operation,the time of removing anesthesia intubation and 2 hours,4 hours,6 hours,12 hours,18 hours and 24 hours after surgery and the results were showed by visual analogue scale(VAS)..In addition,serum concentration of cortisol,catecholamine and glucose were tested at the time of pre-operation and removing anesthesia intubation,and 6 hours,12 hours,and 24 hours after surgery.Furthermore,the general condition,operation time and adverse reactions were recorded.Results:1.There were no significant differences in general conditions and operation time among the three groups(P>0.05),and no significant adverse reactions related to analgesics were observed.2.The VAS scores were no significant differences at the time of pre-operation and removing anesthesia intubation among the three groups(P>0.05).And VAS scores in group C were lower than that in group A and B at 2 hours,4 hours,6 hours,12 hours,18 hours and 24 hours after surgery with statistically significant differences(P<0.05).3.There were no significant differences in the levels of cortisol,catecholamine and blood glucose at the time of pre-operation and removing anesthesia intubation among the three groups(P>0.05).And The levels of serum cortisol,catecholamine and blood glucose in group C were lower than that in group A and group B at 6 hours,12 hours and 24 hours after surgery,with statistically significant differences(P<0.05).Conclusion:The analgesic effect of ropivacaine combined with neostigmine and dexamethasone in the shoulder joint cavity was better than ropivacaine combined with neostigmine and ropivacaine combined with dexamethasone,which could effectively improve the pain of patients after arthroscopic rotator cuff repair and reduce the occurrence of postoperative stress response.