Clinical Research Of Pain Relief Applying Local Infiltration With Mixed Analgesic Drugs In "Vascularized Iliac Crest Grafting" For Osteonecrosis Of The Femoral Head

Objective:Patients of osteonecrosis of the femoral head who used local infiltration anesthesia in the “vascularized iliac crest transposition” were obversed, and the efficacy of local infiltration anesthesia to relief pain was evaluated.Methods:(1) Objection of research: from January 2014 to October 2015, 50 patients of osteonecrosis of the femoral head were taken the “vascularized iliac crest transposition”in affiliated zhongshan hospital joint center of Dalian university, they informed and agreed to cooperate with the clinical study, and were divided into the injected group of 26 cases and the control group of 24 cases randomly.(2) Research methods: intraoperative local infiltration anesthesia was used in the injected group, mixed analgesic drugs including10 mg morphine,268.2mg ropivacaine,50 mg triamcinolone acetonideand,1g ceftezole sodium,added normal saline to 100 ml, the control group used equalvolum normal saline.(3) Results of evaluation:general datas were recorded;recorded the VAS score of the pain at rest and the satisfaction with pain in postoperative 3h,9h, 18 h, 48 h, 5d, 10 d,20d;recorded the consumption of the opioids(fentanyl and morphine) in the period of postoperative 0-6h,6-12 h,12-18 h,18-24 h,24-36 h,36-48 h,and the total consumption within the postoperative48h; Cardiopulmnary dysfunction, central nervous symptoms,wound complications,nausea and vomiting and bone flap healing were recorded.Results: All 50 patients were included in the result analysis.There was no difference in general datas between two groups;Compared to the control group, the injected group had a significant lower VAS score of the pain at rest in postoperative 3h,9h, 18h(P < 0.05); the VAS score of the satisfaction with pain between the two groups was similar(P > 0.05); the consumption of the opioids in the period of postoperative 0-6h、6-12h、12-18 h,and the total consumption within the postoperative 48 h decreased significantly(P < 0.05); less complications were observed in the injected group.Conclusion: For patients of osteonecrosis of the femoral head who take the“vascularized iliac crest transposition”, intraoperative local infiltration anesthesia with mixed analgesic drugs is easy to carry out,it can decreases early postoperative pain,reduces the consumption of the opioids and postoperative complications.