ĐÁNH GIÁ HIỆU QUẢ GIẢM ĐAU SAU PHẪU THUẬT THAY KHỚP HÁNG CỦA PHONG BẾ KHOANG MẠC CHẬU LIÊN TỤC DƯỚI HƯỚNG DẪN SIÊU ÂM BẰNG ROPIVACAIN PHỐI HỢP DEXAMETHASON

Abstract

Objective: To compare the effectiveness of continuous fascia iliaca compartment blocks (FICB) under ultrasound guidance using ropivacaine combined with dexamethasone versus ropivacaine alone for postoperative pain relief following hip arthroplasty, as well as to assess some adverse effects of the two methods. Subjects and Methods: This is a prospective, randomized controlled clinical trial. Sixty patients undergoing hip arthroplasty received postoperative pain relief through ultrasound-guided fascia iliaca catheter placement, with patients self-administering analgesia via bolus after the initial dose. The patients were divided into two groups: Group RD (n=30) received ropivacaine combined with dexamethasone, and Group R (n=30) received ropivacaine alone. Results: The pain relief effectiveness between the two groups was comparable, with the VAS scores at rest and during activity showing no statistically significant difference (p>0.05). However, the duration of pain relief from the initial anesthetic injection until the first bolus for Group RD was 407.10 ± 305.68 minutes, significantly longer than Group R was 308.63 ± 212.99 minutes (p < 0.05). The total amount of ropivacaine used for pain relief in the 72 hours post-surgery was lower in Group RD (210.33 ± 79.64 mg) compared to Group R (288.00 ± 91.32 mg), as well as the number of bolus doses (Group RD: 14.53 ± 7.96; Group R: 22.30 ± 9.13), with both differences being statistically significant (p < 0.05). The levels of muscle weakness and other side effects were low and showed no significant difference between the two groups. Conclusion: Pain relief for hip arthroplasty using FICB with ropivacaine combined with dexamethasone is effective, providing a longer duration of analgesia, with significantly lower amounts of anesthetic and fewer bolus doses compared to the use of ropivacaine alone