加速康复外科模式下鸡尾酒疗法对全膝关节置换后的早期镇痛  

Early analgesia of cocktail therapy after total knee arthroplasty with enhanced recovery after surgery program

作　　者：李尚志 郑得志[1] 刘军[1] Li Shangzhi;Zheng Dezhi;Liu Jun(Department of Orthopedics,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津市天津医院骨科,天津市300211

出　　处：《中国组织工程研究》2021年第18期2794-2798,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:尽管鸡尾酒疗法广泛用于关节置换后的镇痛,但不同配伍方案的镇痛疗效尚未被完全证实。目的:观察加速康复外科模式下鸡尾酒疗法用于全膝关节置换后镇痛的疗效。方法:选择2019年1至5月在天津市天津医院关节外科行单侧全膝关节置换的膝重度骨关节炎患者60例,根据双盲随机的原则分为2组,每组30例。试验组在术中于关节周围注射鸡尾酒配方药物,对照组不做注射处理。比较两组患者术后6,12,24,48,72 h膝关节的静态疼痛目测类比评分、48,72 h膝关节最大屈曲度、直腿抬高的时间、术后阿片类药物补救镇痛率及术后并发症。结果与结论:①试验组术后6,12 h目测类比评分显著低于对照组(P均<0.001);术后阿片类药物补救镇痛率显著低于对照组(P<0.001);②而两组术前一般资料、术后24,48,72 h膝关节静态目测类比评分、48,72 h膝关节最大屈曲度、主动直腿抬高时间,术后并发症发生率相比差异均无显著性意义(P均>0.05);③提示加速康复外科模式下全膝关节置换术中鸡尾酒疗法对于术后早期镇痛是安全有效的。BACKGROUND:Although cocktail therapy is widely used to relieve pain after total knee arthroplasty,the analgesic effect of different combination schemes has not been fully confirmed.OBJECTIVE:To observe the efficacy of cocktail therapy on analgesia after total knee arthroplasty with enhanced recovery after surgery program.METHODS:Sixty patients with severe knee osteoarthritis who underwent unilateral total knee arthroplasty at Tianjin Hospital from January to May 2019 were enrolled.According to the principle of double-blind randomization,they were divided into two groups,30 cases in each group.Patients in the trial group were injected with cocktail formula drugs around the joints in the operation,while patients in the control group did not receive any treatment.Static pain visual analogue scale scores of knee joints at 6,12,24,48,and 72 hours,the maximum flexion of the knee joint at 48 and 72 hours,the initial time of the straight legraising,and postoperative opioid remedy analgesia rate and postoperative complications were compared between the two groups.RESULTS AND CONCLUSION:(1)The visual analogue scale scores of the trial group were significantly lower than those of the control group at 6 and 12 hours after operation(both P<0.001),and the postoperative analgesic rate of opioids was significantly lower in the trial group than that of the control group(P<0.001).(2)There were no statistically significantly differences in the preoperative general data,visual analogue scale scores at 24,48,and 72 hours,knee maximum flexion at 48 and 72 hours,the time of the straight leg-raising,and postoperative complications(both P>0.05).(3)The results indicate that cocktail therapy in total knee arthroplasty is safe and effective for early postoperative analgesia with enhanced recovery after surgery program.

关 键 词：全膝关节置换 鸡尾酒疗法 镇痛 加速康复外科 并发症 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]