| Research background and purposeThe purpose of this study was to compare the analgesic effect of ropivaca combined with betamethasone for Pericapsular Nerve Group(PNGB)block after total hip arthroplasty,and observe the effect of ropivaca combined with betamethasone for PNGB block on perioperative pain score,inflammatory factors,hemodynamic changes,anesthetic dosage,postoperative recovery indicators and adverse reactions after total hip arthroplasty,to explore the rationality of ropivaca combined with betamethasone in the treatment of hip joint replacement in elderly patients.Research object and methodAccording to the inclusion/exclusion criteria,60 patients with unilateral total hip arthroplasty were randomly divided into two groups,with 30 patients in each group.Both groups of patients were treated with general anesthesia combined with PNGB.According to different PNGB drugs,they were divided into two groups: the control group was treated with ropivacaine alone,and the observation group was treated with ropivacaine combined with betamethasone.The VAS scores of patients in the two groups at rest and active state at 5 time points(2h,6h,12 h,24h and 48 h after operation)were recorded.The plasma concentrations of tumor necrosis factor(TNF-α)and interleukin-6(IL-6)were recorded before and at 6h,24 h and 48 h after operation in both groups.The changes of vital signs were recorded during the perioperative period;Intraoperative anesthetic consumption;The first time the patient got out of bed after operation;the number of times remedial analgesia and the number of times the Patient Controlled Intravenous Analgesia(PCIA)was pressed effectively 24 hours and 48 hours after operation;and postoperative adverse reactions and complications.ResultMain results1.There was no statistical difference between the two groups in gender,age,body mass index,lesion location and ASA grade(P>0.05).2.The VAS score of patients in the two groups showed a trend of increase and decrease at rest and active at 2h,6h,12 h,24h,48 h after operation,and the VAS score of patients in the observation group was significantly lower than that in the control group at 12-24 h after operation,with significant difference(P<0.05).3.The concentrations of TNF-α and IL-6 at each time point in the two groups were significantly higher than those before operation at 24 h and 48 h after operation,with significant difference(P<0.05).The concentrations of serum TNF and IL-6 in the observation group at 24 h and 48 h were significantly lower than those in the control group,with significant difference(P<0.05).4.The rate of remedial analgesia was lower than that in the control group(P<0.05).The effective press times of PCIA in the observation group were significantly reduced at 0-24 hours and 24-48 hours after operation(P<0.05).Secondary outcome1.There was no statistically significant difference in MAP and HR between the two groups before anesthesia,at the time of laryngeal mask insertion,at the end of operation,and at the time of laryngeal mask removal(P>0.05).2.The incidence of postoperative adverse reactions in the two groups was not statistically significant(P>0.05).ConclusionRopivacaine combined with betamethasone for pericapsular nerve group in total hip arthroplasty can enhance the postoperative analgesia effect and prolong the analgesia time. |
