解放军医学院学报2017，Vol.38Issue(7)：602-605,4.DOI:10.3969/j.issn.2095-5227.2017.07.003
单膝人工关节置换术后多模式镇痛疗效评价
Effects of multimodal analgesia in pain management after unilateral total knee arthroplasty
摘要
Abstract
Objective To study the effect of multimodal analgesia in pain management after unilateral total knee arthroplasty.Methods Ninety osteoarthritis patients who underwent unilateral TKA in our hospital from September 2014 to August 2016 were included in this study.They were divided into three groups with different analgesia regimens with 30 patients in each group.Group A:preoperative oral celecoxib and tramadol hydrochloride + periarticular "cocktail" injection during operation + patient controlled analgesia pump after surgery.Group B:periarticular "cocktail" injection during operation + patient controlled analgesia pump after surgery without preoperative drugs.Group C:patient controlled analgesia pump after surgery without preoperative drugs and periarticular "cocktail" injection during operation.Visual analogue scale scores and range of motion were selected as indicators of effects at several different time points after the surgery.Results No significant difference was found in the demographic data of the three groups (P ＞ 0.05).The VAS scores were recorded as A(2.5 ± 0.6) ＜ B(2.8 ± 0.6) ＜ C(3.0 ± 0.7)at 6 h,A(3.4 ± 1.1) ＜ B (3.8±0.8) ＜ C(4.2±1.4) at 12h,A(4.5±1.2) ＜ B(4.9±1.3) ＜ C(5.4±0.9) at24h,andA(5.6±1.4) ＜ B(6.1±1.3) ＜ C (6.3 ± 1.4) at 48 h after TKA (P ＜ 0.05,respectively).No significant difference was found between the three groups at 72 h and 7 d after TKA (P ＞ 0.05).The ROM were recorded as A(46.4 ± 5.4) ＞ B(42.5 ± 7.3) ＞ C(40.4 ± 5.2) at 24 h,A(58.6 ± 4.2) ＞ B (56.2 ± 4.7) ＞ C(53.3 ± 6.1) at 48 h,A(64.6 ± 5.2) ＞ B(62.5 ± 8.8) ＞ C(60.3 ± 7.4) at 72 h after TKA (P ＜ 0.05,respectively).No significant difference was found between the three groups at 7 d.Conclusion The study shows that multimodal analgesia benefits to pain management and achieve better ROM in early stage after TKA.关键词
人工膝关节置换/镇痛/疼痛管理/围术期管理Key words
total knee arthroplasty/analgesia/pain management/perioperative management分类
医药卫生引用本文复制引用
文涛,郑诗豪,董纪元..单膝人工关节置换术后多模式镇痛疗效评价[J].解放军医学院学报,2017,38(7):602-605,4.基金项目
国家自然科学青年基金项目(81301564)Supported by the National Natural Science Foundation of China (81301564) （81301564）
