不同模式的超前镇痛方案在全膝关节置换手术中的应用  

Application of Different Preemptive Analgesia in Total Knee Arthroplasty

作　　者：席向东 杨超[1] 王硕 田佳宁 赵江博 陈德胜[2] XI Xiangdong;YANG Chao;WANG Shuo;TIAN Jianing;ZHAO Jiangbo;CHEN Desheng(Ningxia Medicle Univercity,Yinchuan 750004,China;Department of Orthopedics,the General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院脊柱骨科,银川750004

出　　处：《宁夏医科大学学报》2020年第5期500-504,共5页Journal of Ningxia Medical University

基　　金：国家自然科学基金(81760405,81760395,81560364);宁夏自然科学基金(2018AAC02013);宁夏医科大学校级课题重点项目(XZ2018014)。

摘　　要：目的观察塞来昔布、洛芬待因片超前镇痛对骨科围手术期镇痛的疗效。方法选择2018年10月-2019年10月在宁夏医科大学总医院骨科行单侧全膝关节置换手术的患者90例,随机分成A、B、C三组。A组术前3 d给予塞来昔布1粒(1粒200 mg),2次/d,同时术后给予塞来昔布l粒(2次/d)+止痛泵止痛治疗;B组术前3 d给予洛芬待因片(磷酸可待因12.5 mg+布洛芬200 mg)2片,2次/d,同时术后给予洛芬待因片2片(2次/d)+止痛泵止痛治疗;C组入院后不给予口服镇痛药治疗,术后给予止痛泵止痛治疗。观察患者术后VAS评分及膝关节主动活动度。结果A、B组患者术后静息和活动状态的VAS评分均低于C组,B组术后静息及活动的VAS评分低于A组(P均<0.05)。A、B组患者术后不同时刻的膝关节主动活动度均大于C组,B组术后不同时刻膝关节主动活动度大于A组(P均<0.05)。结论膝关节置换患者术前给予超前镇痛可以有效缓解术后疼痛,有助于早期功能锻炼。塞来昔布、洛芬待因片可以作为方便、可靠的超前镇痛药。Objective To observe the effect of Celecoxib and Ibuprofen-CodeineSustained Tablets on perioperative analgesia in orthopaedics.Methods 90 patients who underwent unilateral total knee arthroplasty in General Hospital of Ningxia Medical University from October 2018 to October 2019 were selected.All patients had informed consent and were randomly divided into A,B,C three groups after approval by the hospital ethics committee.Group A were treated with 200 mg Celecoxib(twice a day)3 days before the TKA,at the same time 200 mg Celecoxib(twice a day)and venous pump analgesia were treated after the TKA.Group B were treated with 2 Ibuprofen-Codeine Sustained Tablets(twice a day)3 days before the TKA,at the same time 2 Ibuprofen-Co-deine Sustained Tablets(twice a day)and venous pump analgesia were treated after the TKA.Group C were not treated with oral analgesics before the T-KA,only was given venous pump analgesia.Results The VAS scores of patients in group A and B after surgery were lower than those in group C,and the VAS scores of patients in group B after surgery and rest were lower than those in group A,the differences were statistically significant(P<0.05).The knee joint mobility of patients in group A and B was greater than that in group C at different times after surgery,and the knee joint mobility of group B was greater than that in group A at different times after surgery.The differences were statistically significant(P<0.05).Conclusion Preoperative analgesia can effectively alleviate postoperative pain and contribute to early exercise.Celecoxib and Ib-uprofen-Codeine Sustained Tablets can be used as a convenient and reliable Pr-eemptive analgesias.

关 键 词：超前镇痛 塞来昔布 洛芬待因缓释片 膝关节置换术 

分 类 号：R687.4[医药卫生—骨科学]