关键词: 下肢止血带反应, 神经阻滞, 硫酸镁, 罗哌卡因, 膝关节韧带修复术

Abstract:

AIM: To study the effect of magnesium sulfate mixed ropivacaine femoral nerve block on lower extremity tourniquet reaction in the patients with knee ligament repair. METHODS:A total of 83 patients of underwent arthroscopic knee ligament repair who received therapy from February 2016 to February 2018 in our hospital were selected as research objects, they were randomly divided into treatment group (n=42) and control group (n=41), the two groups were operated under the guidance of ultrasound machine, the treatment group was given 0.375% ropivacaine 15 mL (containing Magnesium Sulfate 0.75 g) mixed injection, and the control group was given 0.375% ropivacaine 15 mL injection, after successful anesthesia, the tourniquet was attached to the root of the thigh and then inflated. The onset time, duration and analgesic time of sensory and motor block, the changes of the hemodynamics, serum malondialdehyde (MDA) and tumor necrosis factor-alpha (TNF-α) at different time points were compared between the two groups, and the incidence of tourniquet reaction and adverse drug reactions were recorded. RESULTS:Compared with the control group, the onset time of sensory block and motor block in the treatment group was shorten, and the duration and analgesic time were extend (P<0.05); there were significant differences in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) between the two groups at different time points(P<0.05); the serum MDA and TNF-α at T7 and T8 in the treatment group were higher than those in the control group(P<0.05); the tourniquet reactions were 7.14%（3/42）and 24.39%（10/41） respectively in the two groups, the difference was statistically significant(P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups（P>0.05). CONCLUSION:Magnesium sulfate mixed ropivacaine femoral nerve block is well for lower extremity surgery，which can effectively maintain hemodynamic stability, prolong block effect, relieve oxidative stress and inflammatory reaction, reduce tourniquet reaction, and has high safety. It is worthy of application and promotion.

Key words: lower extremity tourniquet reaction, nerve block, magnesium sulfate, ropivacaine, knee ligament repair