中山大学学报（医学科学版）2012，Vol.33Issue(2)：202-205,4.
无痛病房模式在早期人工膝关节置换术后的效果评价
Effect of a Model of Nurses' Pain Management Practice after Total Knee Arthroplasty
摘要
Abstract
[ObjectivejTo evaluate the effect of a model of nurses' pain management practice after total knee arthroplasty (TKA). [Methods] Two cohorts of 100 TKA patients were selected from Department of Joint Surgery, the First Affiliated Hospital of Sun Yat-Sen University before and after the initiation of the protocol from February 2009 to September 2009. They were divided into study group(n = 50) and control group (re = 50). Fifty patients of the study group received a model of nurses' pain management practice; All patients pro-operation 48 hours and post-operation 24 hours the next day for celecoxib (Celebrex) 200 mg bid (after 6 hours 400 mg orally), paracetamol and tramadol a tid oral, continuous use of 14 days,and received intraoperative periarticular injection of multimodal drugs (consisting of 10 g/L ropivacaine 20 mL, morphine 5 mg, normal saline 60 mL), drug injection around the joint not used in patients of the control group. Pethidine used in patients with pain after the first 6 h, the same dose given as the case once again. Activities and visual analogue pain score were recorded before and after surgery. Clinical follow-up included EuroQol (EQ-5D) scores, preoperative and postoperative KSS knee score. [Results] A total of 88 patients involved in the result analysis. (1) Visual analogue pain score; The patients of the study group had significantly lower rest pain scores and activity pain scores at 6, 12, 24, and 48 h after operation than the control group. There were no significant differences at 72 h after operation; (P < 0.01); (2) Average KSS scores were 36 ± 6, 34 ± 6 points preoperatively and 89 ± 11, 89 ± 10 points at final follow-up (P > 0.05); (3) Average EQ-5D scores was 0.79 ± 0.16 points in study group and 0.77 ± 0.21 points in study group in control group at final follow-up. There wereno significant differences between both; (3) There were no significant differences in complications such as wound healing, incidence rate of infection, stiffness and so on. [Conclusions] A model of nurses' pain management practice was shown to safely provide excellent pain control and functional recovery after surgery early.关键词
镇痛/关节置换术/膝Key words
total knee arthroplasty/ pain/ functional recovery分类
医药卫生引用本文复制引用
方淑莺,康焱,黄天雯,廖威明..无痛病房模式在早期人工膝关节置换术后的效果评价[J].中山大学学报（医学科学版）,2012,33(2):202-205,4.基金项目
国家自然科学基金(81171709) （81171709）
