Complications, Pain
Conditions
Keywords
Local analgesia system, Ropivacaine, Analgesic efficacy after operation, Postoperative
Brief summary
Pain after amputation is a significant problem among amputees. Phantom limb pain may appear in up to 85% of patients and is usually resistant to a wide variety of treatments.It is believed that regional anesthesia, by preventing the establishment of central sensitization, may play a role in reducing the incidence of acute and chronic pain. Therefore the investigators will compare two methods of postoperative analgesic after after amputation by their efficiency and complication.
Detailed description
Peripheral nerve transection results in an afferent nociceptive barrage that initiates spinal cord hyperexcitability with expansion of the receptive fields of dorsal horn neurons that respond to the nearest intact afferents. These neuroplastic changes are believed to be responsible for the development of postsurgical chronic pain syndromes, including phantom limb and stump pain.At present, there are no randomized studies with sample sizes that ensure power, or blinded for end-point assessment,to support the evidence on pharmacological and non-pharmacological treatments of Pain after amputation. Consequently, our study was designed to arrive at clear conclusions about treatment efficacy and to give stronger recommendations for clinical practice.
Interventions
PROCEDURELocal analgesic
Patient will be performed under combined lumbar plexus and sciatic nerve block with 0.33% ropivacaine.At the end of surgery,two catheters are left in the wound.One is intraarticular and the other is on the surface of articular cavity.And then a pump elastomeric infusion pump will be connected with the catheters, which runs 5mL every hours.
PROCEDUREIntravenous analgesic
People in this group will also receive an anesthesia of combined lumbar plexus and sciatic nerve block with 0.33% ropivacaine.An intravenous electronic analgesia pump infusion of flurbiprofen axetil 250mg,palonosetron 0.5mg,pentazocine 240mg.dezocine 30mg will will provide postoperative pain management.The patients will received a 2 mL/h continuous basal infusion and 1 mL boluses with a lockout time of 30 min after a 5 mL Loading dose at the end of the surgery.
DRUGropivacaine
0.2% ropivacaine
DRUGflurbiprofen
flurbiprofen axetil 250mg,palonosetron 0.5mg,pentazocine 240mg.dezocine 30mg
Sponsors
Guangzhou General Hospital of Guangzhou Military Command
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
1. Patients of American Association of anesthetists（ASA）Grade 1 or 2 2. Aged between 18 and 65 years 3. Undergoing elective total knee replacement
Exclusion criteria
1. Mental illness can not match 2. Nerve block, epidural anesthesia contraindicated 3. People who have Slow-type arrhythmias 4. History of chronic headaches and long-term use of analgesic drugs 5. People who were postoperative consciousness, language or hearing impaired
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain | 72 hours postoperation | Up to 72 hours after operation,postoperative pain visual analogue scale(VAS) scores are used to evaluate the level of pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Phantom pain | three months postoperation | Investigators asked the patient wether there is phantom pain at three months after surgery |
| complication | 72 hours postoperation | Investigators document the incidence of nausea,vomiting,headache,urinary retention and et al |
Countries
China
Contacts
Primary Contactbo xu, associate chief physician
Outcome results
None listed