无背景剂量的病人自控静脉镇痛在全膝关节置换术后的镇痛效果观察  

The analgesic effect of patient-controlled intravenous analgesia without background infusion in total knee arthroplasty

作　　者：闫学美 郎堡[2] 于洋 袁方 兰楠楠 翟永吉 YAN Xuemei;LANG Bao;YU Yang;YUAN Fang;LAN Nannan;ZHAI Yongji(Department of Anesthesiology,Weifang Medical University,Weifang 261053,China;Department of Anesthesiology,Weifang People's Hospital)

机构地区：[1]潍坊医学院麻醉学院,山东潍坊261053 [2]潍坊市人民医院麻醉科

出　　处：《潍坊医学院学报》2020年第4期317-320,共4页Acta Academiae Medicinae Weifang

摘　　要：目的观察无背景剂量的病人自控静脉镇痛(PCIA)在全膝关节置换术(TKA)后的镇痛效果,为临床的术后镇痛方案提供参考。方法选取64例行择期全膝关节置换术的患者,用随机数字表法分为实验组(Z组)和对照组(C组),每组32例,实验组采用无背景剂量输注的病人自控静脉镇痛,对照组采用背景剂量输注的病人自控静脉镇痛,术后随访48h,记录两组患者术后2h,6h,12h,24h,48h静息与运动时的视觉模拟评分(VAS),术后0~12h和0~48h镇痛泵药物输注用量,镇痛泵按压次数和补救药物用量,术后恶心、呕吐、瘙痒等不良反应的发生情况,术后镇痛效果的满意度评分。结果术后2h,6h,12h,24h,48h患者静息与运动时的VAS评分,术后0~12h和0~48h镇痛泵按压次数和镇痛效果的满意度评分差异无显著性(P>0.05)。术后0~12h和0~48h补救药物用量差异无显著性(P>0.05),术后不良反应发生率差异无显著性(P>0.05),术后0~12h和0~48h镇痛泵药物输注总量实验组低于对照组,且两组输注药物总量的比较差异有显著性(P<0.05)。结论与背景剂量输注下的病人自控静脉镇痛相比,无背景剂量的病人自控静脉镇痛可提供与之相同的镇痛效果,但是无背景剂量组阿片类药物用量更少。Objective To explore the analgesic effect of patient-controlled postoperative intravenous analgesia without background infusion in total knee arthroplasty and providing a reference for the clinical postoperative analgesia program.Methods Sixty-four patients who underwent total knee arthroplasty were selected and randomly divided into experimental group(Z group) and control group(C group).Patient-controlled intravenous analgesia without background infusion was used in the experimental group,while patient-controlled intravenous analgesia with background infusion was used in the control group,followed up for 48 h after operation,and recorded the visual analog score at rest and exercise at 2 h,6 h,12 h,24 h,and 48 h after operation in both groups.And the dosage of analgesic pump infusion,the number of times of analgesic pump pressing,the complementary analgesics,the side effects and the satisfaction score of postoperative analgesic effect were also recorded.Results At 2 h,6 h,12 h,24 h,and 48 h after operation,the VAS scores of resting and exercising patients were not statistically significant between 0~12 h and 0~48 h postoperative analgesic pump compression times and analgesic effect satisfaction scores(P>0.05).The doses of complementary analgesics or side effects or the satisfaction score of postoperative analgesic effect also have no significant differences(P>0.05).The total amount of analgesic pump infusion at 0~12 h and 0~48 h after operation was lower in the experimental group than in the control group,which has statistically significant difference(P<0.05).Conclusion Compared with patient-controlled intravenous analgesia with background infusion,patient-controlled postoperative intravenous analgesia without background infusion provided the same analgesic effect,but opioid dosage in the backgroup-free dose group is less.

关 键 词：病人自控静脉镇痛 无背景剂量输注 神经阻滞 全膝关节置换术 

分 类 号：R687.4[医药卫生—骨科学]