全膝关节置换后鸡尾酒疗法的镇痛效应  

Application of"cocktail wine"in pain relief after total knee arthroplasty

作　　者：李恒[1,2] 隋福革[1,2] 张宁宁[1,2] 汪群[1,2] 王东军[1,2] 王强[1,2] 何晓峰[1,2] 

机构地区：[1]大庆龙南医院骨科 [2]齐齐哈尔医学院第五附属医院骨科,黑龙江省大庆市163453

出　　处：《中国组织工程研究与临床康复》2011年第26期4795-4797,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:关节周围注射混合镇痛药物(鸡尾酒疗法)是比较新颖的人工关节置换后镇痛方法,可以较好的控制置换后疼痛,减少不良反应。目的:评估全膝关节置换过程中关节周围注射混合药物在置换后镇痛方案中的止痛效果。方法:选择26例实施单侧全膝关节置换患者,术中关节周围注射"鸡尾酒"镇痛药液(包括罗哌卡因200mg、肾上腺素5mg、曲安奈德5mg),记录患者置换前后静止与活动目测类比疼痛评分、膝关节活动度、主动直腿抬高时间及伤口并发症等。结果与结论:所有患者均未使用胃肠外阿片类药物,置换后1～3d静息痛和运动痛目测类比评分均获得显著改善,主动直腿抬高时间平均为2.5d,置换后第二三天的膝关节平均主动活动度各为45°和55°,置换后关节活动度明显改善,无伤口感染、延期愈合及组织坏死等并发症。说明全膝关节置换中应用关节周围注射该镇痛药物在可减少置换后早期静止和活动状态疼痛评分,改善置换后早期关节活动度,且简单实用、安全有效。BACKGROUND：＂Cocktail wine＂ therapy is a new way for pain relief after total knee arthroplasty with fewer side effects.OBJECTIVE：To observe the early efficacy of postoperative periarticular injection of multimodal analgesia（＂cocktail wine＂ treatment） after total knee arthroplasty.METHODS：Twenty-six patients undergoing unilateral total knee arthroplasty had the same treatment of pain relief perioperatively.All the cases were injected with the ＂cocktail wine＂ intraoperatively.The postoperative visual analogue scale（VAS） of pain,the range of motion of knee joint and wound complications were analyzed versus the preoperative data.RESULTS AND CONCLUSION：All the patients did not take the medicine of parenteral opiods,and there were significant improvement in pain VAS during rest and exercise for 1-3 days postoperatively.Time for active straight leg lifting was 2.5 days postoperatively in average.During the 2nd and 3rd days postoperatively,the average knee joint activities were 45° and 55°,and no wound complications occurred.These demonstrated that the periarticular injection of analgesia can reduce the scores of the VAS during rest and exercise and improve the activity of knee joints in the early stage,and it is simple,practical,safe and effective.

关 键 词：鸡尾酒疗法 全膝关节置换 局部浸润 关节内 镇痛 

分 类 号：R318[医药卫生—生物医学工程]