丁丙诺啡透皮贴联合PCIA在全膝关节置换术后镇痛中的应用疗效  

Outcome of buprenorphine transdermal patch combined with PCIA applied to postoperative analgesia after total knee arthroplasty

作　　者：李红艳 陈金 王娅 李敏 程雪莲 LI Hong-yan;CHEN Jin;WANG Ya;LI Min;CHEN Xue-lian(Department of Orthopedics,Yiling Hospital of Yichang,Yichang Hubei 443100,China)

机构地区：[1]宜昌市夷陵医院骨科,湖北宜昌443100

出　　处：《局解手术学杂志》2021年第5期442-445,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：宜昌市应用基础研究项目(A19-301-54)。

摘　　要：目的探讨丁丙诺啡透皮贴联合自控静脉镇痛泵(PCIA)用于膝关节置换术后镇痛的疗效。方法选取因膝关节骨性关节炎行单侧人工膝关节置换术的80例患者,将其随机分为治疗组(术前1 d采用丁丙诺啡透皮贴+PCIA)和对照组(单纯应用PCIA),每组40例。观察比较2组患者术后静态和动态VAS评分、PCIA按压次数、膝关节活动度、补救镇痛药物使用量以及药物不良反应发生率。结果治疗组在术后6 h、12 h、1 d、2 d、3 d的静态和动态VAS评分均明显低于对照组,差异有统计学意义(P<0.05);而术后4 d、7 d、14 d 2组静态和动态VAS评分比较差异无统计学意义(P>0.05)。治疗组在术后2 d内PCIA按压次数、术后补救镇痛药物使用量均明显少于对照组,差异有统计学意义(P<0.05)。治疗组患者术后3 d、4 d、7 d、14 d膝关节活动度明显大于对照组,差异有统计学意义(P<0.05);2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论丁丙诺啡透皮贴联合PCIA应用于膝关节置换术后镇痛是一种安全有效的镇痛方法,对术后疼痛的控制效果显著,可减少患者术后补救镇痛药物的使用,促进膝关节功能早期恢复,且不良反应少。Objective To investigate the outcome of buprenorphine transdermal patch combined with patient controlled intravenous analgesia(PCIA)for postoperative analgesia after total knee arthroplasty.Methods Totally 80 patients with knee osteoarthritis underwent unilateral total knee arthroplasty were selected and randomly divided into the treatment group(received buprenorphine transdermal patch+PCIA 1 day before operation)and the control group(received PCIA only),with 40 cases in each group.The static and dynamic visual analogue scale(VAS)score,PCIA pressing times,knee range of motion,assumption volume of remedial analgesic drugs and incidence of adverse drug reactions of the two groups were observed and compared.Results The static and dynamic VAS scores of the treatment group 6 hours,12 hours,1 day,2 days,3 days after operation were significantly lower than those of the control group(P<0.05),whereas there was no significant difference in the static and dynamic VAS scores between the two groups 4 days,7 days and 14 days after operation(P>0.05).The PCIA pressing times and the consumption volume of postoperative remedial analgesic drugs in the treatment group within 2 days after operation were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The knee range of motion of the treatment group 3 days,4 days,7 days and 14 days after operation was significantly higher than that of the control group,the difference was statistically significant(P<0.05);there was no significant difference in the incidence of adverse reaction(P>0.05).ConclusionBuprenorphine transdermal patch combined with PCIA is a safe and effective analgesic method for postoperative pain control after total knee arthroplasty,which can control postoperative pain significantly,reduce the comsumption of postoperative remedial analgesic drugs,promote the early recovery of knee joint function,and have less adverse reactions.

关 键 词：全膝人工关节置换 丁丙诺啡透皮贴 镇痛 自控静脉镇痛泵 

分 类 号：R687.4[医药卫生—骨科学]