Abstract：【Objective】 To investigate the effect of ropivacaine combined with dexmedetomidine continuous femoral nerve block on analgesia, sleep quality and postoperative delirium in elderly patients with total knee arthroplasty. 【Methods】 A total of 106 elderly patients with total knee replacement who will be treated in our hospital from May 2016 to October 2018 were selected.The patients were randomly divided into control and observation groups by random number table method, with 53 patients in each group.All patients underwent continuous femoral nerve block under ultrasound guidance in both groups, while the control group was administered 0.2% ropivacaine 200ml and the observation group was administered 0.2% ropivacaine 200ml+ 4ug / kg dexmedetomidine.The efficacy of analgesia, quality of sleep, postoperative delirium and occurrence of postoperative complications were compared between the two groups. 【Results】 The numerical rating scale (NRS) and the delirium assessment scale in the ICU (CAM-ICU) scores on postoperative days 1, d2, and d3 were significantly lower in the observation group compared with the control group (P<0.05), and the resting visual analog scale (VAS) scores and motor VAS scores on postoperative days 6, 12, and 24 in the observation group were lower than those in the control group (P<0.05).Satisfaction with analgesia in the observation group was 75.5% (40 / 53) higher than that in the control group at 56.6% (30 / 53) (P<0.05).The number of analgesic pump compressions in the observation group was lower than that in the control group, and the difference was significant (P<0.05).【Conclusion】 Ropivacaine combined with dexmedetomidine continuous femoral nerve block enhances postoperative analgesia, effectively improves sleep quality, and reduces the occurrence of postoperative delirium in elderly patients undergoing total knee replacement.
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2021, Vol. 38 
