膝关节镜围术期应用塞来昔布镇痛疗效观察  

Analgesic efficacy of perioperative celecoxib in arthroscopic knee surgery

作　　者：林松[1] 许建中[1] 李文辉[1] 卞春喜[1] 张大伟[1] 汪淼[1] 

机构地区：[1]郑州大学第一附属医院骨科,450052

出　　处：《中国实用医刊》2009年第1期19-21,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察膝关节镜围术期患者应用塞来昔布的镇痛疗效。方法选择我院2007年6月至2008年6月住院接受关节镜治疗患者93例，随机分成三组：A组（术后使用组，术后2h口服塞来昔布200mg）；B组（术前预用＋术后使用组，术前1h＋术后2h均口服塞来昔布200mg）；C组（安慰剂对照组，与B组用药时间一致，药物为簧慰剂）。分别于术后2、4、8、12、24、48h行可视痛觉评分（VAS）统计，观察患者术后至第一次使用阿片类药物的时间间隔及总使用量及患者术后膝关节功能锻炼情况。结果A、B组VAS统计在术后2、12、24．48h差异无统计学意义（P〉0．05），B纽术后4、8hVAS值显著低于A纽和C组（P〈0．01），C组各时间点VAS值均最高；B组术后至第一次使用救援镇痛药的间隔时间最长、使用量最少（P〈0．05），术后患者膝关节屈曲达90a的时间C组所需时间最长（P〈0．01）。结论膝关节镜围术期应用塞来昔布具有良好的超前镇痛及术后镇痛效果，可减少术后阿片类药物的使用量，有利于患者的早期康复。Objective To assess the effects of perioperative celecoxib administration in pain management of patients undergoing arthroscopic knee surgery. Methods From June 2007 to June 2008.93 cases who received the arthroscopie knee operation were divided into three groups at random. Group A （ administrated celecoxib 2 h post -operative, oral 200 mg） ;Group B （administrated cetecoxib 1 h pre -operative and 2 h post -operative. oral 200 nag every time） ;Group C was control group （ placebo oral 1 h pre - operative and 2 h post -operative like group B）. Afire surgery, pain intensity at 2.4.8,12,24 and 48 h was measured with visual analogue scale （VAS）, and the time their first request for pain medication, the total opoid consumption and the post - operative function exercise were recorded. Results The VAS of group A and group B at 2.12.24.48 h had no difference（ P 〉0.05 ）.the VAS of group B was lower than group A and group C at 4 h.8 h（ P 〈0.01 ） ,group C was higher than group B and group A at each time -point. It raked the longest time of group B from operation to the first time to use opioid. Also. the consumption of opioid of group B was the least. Group C needed the longest time for flexion of knee to arrive 90 degree （P 〈 0.05 ）. Conclusions Celecoxib has obvious preemptive and post -operative analgesia effect in artoroseopic knee operation. It can greatly reduce the consumption of opioid and benefit to the patients.

关 键 词：膝关节镜 塞来昔布 镇痛 疗效 

分 类 号：R687[医药卫生—骨科学]